Individual
DR. GREGORY LEON PATERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
750 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-6049
(616) 949-2600
(616) 954-0213
Mailing address
750 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-6049
(616) 949-2600
(616) 954-0213
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002424
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410044294
MEDICARE RR
MI
05
—
4249619
—
MI
01
—
900C46507
BCBS
MI
Enumeration date
06/13/2005
Last updated
06/09/2008
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