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NPI Code Detail

MEDICARE: DR. PAUL JAMES GRENIER O.D.

MEDICARE: DR. PAUL JAMES GRENIER O.D.
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
1152W00000XOptometrist046-009510IL
2152W00000XOptometrist4901004452MI

General Provider Information

NPI Number : 1386608081
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL JAMES GRENIER O.D.
Provider Business Mailing Address
First Line : 3621 S STATE ST
Second Line :
City : ANN ARBOR
State : MI
Zip : 48108-1633
Country : US
Telephone Number : 734-647-5299
Fax Number :
Provider Business Practice Location Address
First Line : 1000 WALL ST
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-1912
Country : US
Telephone Number : 734-764-4190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 03/07/2023

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