Individual
GREGORY M GREWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1789 SHAWANO AVE, GREEN BAY, WI 54303
(920) 499-1428
(920) 499-5808
Mailing address
1789 SHAWANO AVE, GREEN BAY, WI 54303-3243
(920) 499-1428
(920) 499-5808
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
30051-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1018806004
UNITED HEALTHCARE AMERICH
—
05
—
31476800
—
WI
05
—
4838144
—
MI
05
—
4838153
—
MI
01
—
P00287110
RR MEDICARE
—
Enumeration date
07/12/2006
Last updated
12/05/2017
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