Individual
DR. GREGG WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-5190
(248) 964-5199
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1865
(947) 522-0307
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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