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General NPI Number Information
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NPI Number | 1952614497
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Entity Type | Individual
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Provider Name | GARETT PANGRAZZI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 2770 E BELTLINE AVE NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-8614
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Country | US
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Telephone | 616-267-8860
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MICHIGAN ST NE # MC845
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301096379
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 4301096379
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License Number State | MI
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