# JOANNE MARIE GRZESZAK DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619147493
- **Authorized official:** JOANNE M GRZESZAK DO (PROVIDER)
- **Authorized official phone:** (616) 452-8923

## Contact information

- **Practice address:** 806 ALGER ST SE, GRAND RAPIDS, MI 49507-3803
- **Practice address phone:** (616) 452-8923
- **Mailing address:** 4310 LEONARD ST NW, SUITE 103, WALKER, MI 49534-8447
- **Mailing address phone:** (616) 453-6329
- **Mailing address fax:** (616) 453-1725

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 00714 | MI | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2008
- **Last updated:** 01/19/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0154100134 | BCBSM | — |
| 05 | — | 2812013 | — | MI |
| 01 | — | 54100135 | BCBS | MI |