Gray, Jerry Mcnicoll

Gray, Jerry Mcnicoll is an sole proprietor health care provider with primary practice located at 145 Columbia Ave , Holland MI 49423-2987. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology, which is considered as his primary health care specialty. Gray, Jerry Mcnicoll can be contacted via phone (734) 255-3884.

Contact Information

Primary practice address
145 Columbia Ave Holland MI 49423-2987
Fax: (734) 971-7079
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207ZH0000X 4301023740 Michigan

Profile Details

NPI number 1477761195
LBN Legal business name Gray, Jerry Mcnicoll
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 18th, 2007
Last updated Aug 23rd, 2019 - about 7 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 1477761195 NPPES
Michigan Other 4301023740 PHYSICIAN LICENSE

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