Individual
GREGORY S MERVENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 MICHIGAN ST NE, SUITE 4400, GRAND RAPIDS, MI 49503-2562
(616) 391-9945
(616) 486-6346
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301060010
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301060010
MI
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
Primary
4301060010
MI
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
4301060010
MI
Other
Enumeration date
07/17/2006
Last updated
04/02/2014
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