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NPI Code Detail

MEDICARE: DAVID A GREKIN MD

MEDICARE:   DAVID A GREKIN  MD
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
1207N00000XDermatology Physician4301036713MI

General Provider Information

NPI Number : 1316057045
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID A GREKIN MD
Provider Business Mailing Address
First Line : 801 YORK ST
Second Line :
City : MANITOWOC
State : WI
Zip : 54220-4630
Country : US
Telephone Number : 920-663-9008
Fax Number : 920-684-1439
Provider Business Practice Location Address
First Line : 4020 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1737
Country : US
Telephone Number : 260-423-2567
Fax Number : 260-420-2415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 10/06/2023

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Directions to “ DAVID A GREKIN MD” Practice Location

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