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Individual

MR. GREGORY JAMES NIEDZWIECKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1215 E MICHIGAN AVE, C/O EMERGENCY DEPARTMENT, LANSING, MI 48912-1811
(517) 364-1000
Mailing address
1215 E MICHIGAN AVE, C/O EMERGENCY DEPARTMENT, LANSING, MI 48912-1811
(616) 364-1000

Taxonomy

Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
3202006021
MI
363A00000X
Physician Assistant
Primary
5601005718
MI

Other

Enumeration date
05/03/2010
Last updated
12/18/2014
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