Individual
GREGG THOMAS MALICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
14755 215TH AVE, BIG RAPIDS, MI 49307-9224
(231) 796-3200
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101020109
MI
Other
Enumeration date
06/28/2012
Last updated
04/22/2024
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