Individual
GARY L MARSIGLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1471 GRACE ST SE, GRAND RAPIDS, MI 49506-1678
(616) 913-2011
(616) 913-2005
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, GRAND RAPIDS, MI 49519-9606
(616) 252-3243
(616) 252-0260
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101007137
MI
207QG0300X
Geriatric Medicine (Family Medicine) Physician
5101006361
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487618666
—
MI
Enumeration date
04/14/2006
Last updated
12/05/2017
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