Gradolph, Paul Richard

Gradolph, Paul Richard is an individual health care provider with primary practice located at 43421 Garfield Rd Ste 1, Clinton Twp MI 48038-1133. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gradolph, Paul Richard can be contacted via phone (586) 286-5500.

Contact Information

Primary practice address
43421 Garfield Rd Ste 1 Clinton Twp MI 48038-1133
Phone: (586) 286-5500
Fax: (586) 286-0900
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X PG034110 Michigan

Profile Details

NPI number 1417946815
LBN Legal business name Gradolph, Paul Richard
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Dec 22nd, 2020 - about 6 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 1417946815 NPPES
Michigan MEDICAID 4362474

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