Individual
DR. GREGORY A. BAMBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7870W US HIGHWAY 2, MANISTIQUE, MI 49854-8992
(906) 341-2143
(906) 341-3299
Mailing address
7870W US HIGHWAY 2, MANISTIQUE, MI 49854-8992
(906) 341-2143
(906) 341-3299
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
39912
MN
208600000X
Surgery Physician
Primary
GB059652
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4992780
—
MI
05
—
812880500
—
MN
Enumeration date
06/14/2006
Last updated
01/24/2014
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