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NPI Code Detail

MEDICARE: DR. JEFFREY GRESKI DO

MEDICARE: DR. JEFFREY GRESKI DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianJG012005MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1340F375640OTHERMIBCBSM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073619441
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY GRESKI DO
Provider Business Mailing Address
First Line : 2450 WALTON BLVD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48309-1481
Country : US
Telephone Number : 248-650-0096
Fax Number : 248-650-9831
Provider Business Practice Location Address
First Line : 2450 WALTON BLVD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48309-1481
Country : US
Telephone Number : 248-650-0096
Fax Number : 248-650-9831
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JEFFREY GRESKI DO” Practice Location

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