Individual
GRETCHEN J ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
145 MICHIGAN ST NE, SUITE 3410, GRAND RAPIDS, MI 49503-2562
(616) 391-9945
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301089367
MI
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
4301089367
MI
207P00000X
Emergency Medicine Physician
4301089367
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301089367
MI
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
4301089367
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00416276
RAILROAD MEDICARE
MI
Enumeration date
03/06/2007
Last updated
02/22/2021
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