Individual
DR. WALTER GREGORY KORYTOWSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3333 SPRING ARBOR RD, SUITE 400, JACKSON, MI 49203-8605
(517) 783-6435
(517) 783-6347
Mailing address
3333 SPRING ARBOR RD, SUITE 400, JACKSON, MI 49203-8605
(517) 783-6435
(517) 783-6347
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301040841
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0320049
PHP MICHIGAN
MI
01
—
0703800982
BLUE CROSS BLUE SHIELD MI
MI
05
—
1570689
—
MI
01
—
4301040841
MEDICAL LICENSE NUMBER
MA
01
—
P58275
BLUE CHOICE/CARE NETWORK
MI
Enumeration date
08/21/2006
Last updated
10/11/2011
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