Individual
GREGORY R NEAGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2122 HEALTH DR SW, WYOMING, MI 49519-9698
(616) 252-5220
(616) 252-5770
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
GN406993
MI
207RP1001X
Pulmonary Disease Physician
Primary
GN406993
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423967710
—
MI
Enumeration date
03/29/2006
Last updated
03/17/2018
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