Individual
JERRY MICHAEL GREIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
15855 NINETEEN MILE ROAD, EMERGENCY MEDICINE DEPARTMENT, CLINTON TWP, MI 48038-3504
(586) 493-8000
Mailing address
38935 ANN ARBOR ROAD, CREDENTIALING/PAYER CONTRACTING SERVICES, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101014273
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11277479
CAQH
—
05
—
114522460
—
MI
01
—
JG014273
BCBS
—
Enumeration date
06/14/2006
Last updated
04/12/2011
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