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Individual

DR. GEOFFREY RICHES GRAMBAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 JOHN ST, SUITE M-401, KALAMAZOO, MI 49007-5342
(269) 388-5864
(269) 388-5211
Mailing address
601 JOHN ST, SUITE M401, KALAMAZOO, MI 49007-5341
(269) 388-5864
(269) 388-5211

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
GG035172
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
114393
GRT LKS HLTH PLAN
05
1386427
MI
01
290009377
RAILROAD MEDICARE
MI
01
290394238
BCBS IND PIN
01
290C913410
BCBS GRP PIN
01
290C96034
BC/BS OF MICHIGAN
MI
01
382356205107
COMMUNITY CHOICE OF MICH
MI
01
4379439
AETNA
01
4809117
PHP
01
4830052
PHP
MI
01
P64591
BLUECARE NETWORK
MI
Enumeration date
09/12/2006
Last updated
11/27/2023
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