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Individual

JAN C GROMADA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
420 LAKE NEPESSING RD, LAPEER, MI 48446-2961
(810) 245-9011
Mailing address
420 LAKE NEPRESSING RD, LAPEER, MI 48446
(810) 245-9011

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
JG006098
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1015855
MCLAREN HEALTH PLAN
MI
05
114737651
MI
01
114901620
MOLINA
MI
01
141205
CARE CHOICES
MI
01
1654410124
BCBS
MI
01
1G00026
HEALTH PLAN OF MICHIGAN
MI
01
C1522
MCARE HMO
MI
Enumeration date
07/23/2006
Last updated
12/10/2012
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