Gradis, Glenn A

Gradis, Glenn A is an individual health care provider with primary practice located at 3950 S Rochester Rd Suite 1200, Rochester Hills MI 48307-5160. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gradis, Glenn A can be contacted via phone (248) 844-6000.

Contact Information

Primary practice address
3950 S Rochester Rd Suite 1200 Rochester Hills MI 48307-5160
Phone: (248) 844-6000
Fax: (248) 844-6159
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101006988 Michigan

Profile Details

NPI number 1679543292
LBN Legal business name Gradis, Glenn A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Dec 6th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679543292 NPPES
Michigan Other 700H273300 BLUE SHIELD GROUP
Michigan MEDICAID 1679543292 BLUE SHIELD GROUP

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