Organization
JOANNE MARIE GRZESZAK DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE M GRZESZAK DO (PROVIDER)
(616) 452-8923
Entity
Organization
Contact information
Practice address
806 ALGER ST SE, GRAND RAPIDS, MI 49507-3803
(616) 452-8923
Mailing address
4310 LEONARD ST NW, SUITE 103, WALKER, MI 49534-8447
(616) 453-6329
(616) 453-1725
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
00714
MI
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0154100134
BCBSM
—
05
—
2812013
—
MI
01
—
54100135
BCBS
MI
Enumeration date
03/07/2008
Last updated
01/19/2010
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