Individual
DR. GREGG WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
5101011119
MI
2085R0202X
Diagnostic Radiology Physician
Primary
5101011119
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184651366
—
MI
01
—
700F281060
BLUE CARE NETWORK
MI
01
—
700F314390
BLUE SHIELD
MI
Enumeration date
06/26/2006
Last updated
07/21/2022
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