Individual
GREGORY J CERILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5301 E. HURON RIVER DR., YPSILANTI, MI 48197
(734) 712-7017
(734) 712-2844
Mailing address
PO BOX 0446, 24 FRANK LLOYD WRIGHT DR. LOBBY J, ANN ARBOR, MI 48106
(419) 291-5150
(419) 479-6173
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35069105
OH
2086S0102X
Surgical Critical Care Physician
Primary
4301104239
MI
2086S0127X
Trauma Surgery Physician
4301104239
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000522576
ANTHEM
—
01
—
04572
PARAMOUNT
—
05
—
1194720284
—
MI
05
—
2482942
—
OH
01
—
7077263
AETNA
—
01
—
P00462488
RRMC
—
Enumeration date
06/16/2005
Last updated
07/21/2022
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