Individual
DR. GREGG POLIDORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 W 13 MILE RD, STE 202, ROYAL OAK, MI 48073-6770
(248) 551-0900
(248) 551-0905
Mailing address
3535 W 13 MILE RD, STE 202, ROYAL OAK, MI 48073-6770
(248) 551-0900
(248) 551-0905
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301407183
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2836230
—
MI
Enumeration date
11/02/2005
Last updated
10/20/2020
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