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Individual

GREGORY J FORTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5020 W BRISTOL RD, FLINT, MI 48507-2919
(810) 732-1620
(810) 732-8559
Mailing address
5020 W BRISTOL RD, FLINT, MI 48507-2919
(810) 732-1620
(810) 732-8559

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
GF048390
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0202532841
BC/BS OF MICHIGAN
MI
01
0210222032
HEALTHPLUS OF MICHIGAN
MI
01
105381
PREFERRED CHOICE PPO
MI
01
109241
GREAT LAKES HEALTH PLAN
ME
01
204107
MCLAREN HEALTH PLAN/ADVAN
MI
05
2607980
MI
01
382237803112
COMMUNITY CHOICE
MI
01
4294605
AETNA
MI
01
B63761
HEALTH ALLIANCE PLAN
MI
01
C1986
M-CARE
MI
Enumeration date
02/02/2006
Last updated
11/27/2007
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