Individual
GREGORY GLENN MESSENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 LAKE LANSING RD, SUITE A, LANSING, MI 48912-3753
(517) 487-0128
(517) 487-2639
Mailing address
1515 LAKE LANSING RD, SUITE A, LANSING, MI 48912-3753
(517) 487-0128
(517) 487-2639
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
GM044698
MI
207ND0101X
MOHS-Micrographic Surgery Physician
GM044698
MI
207ND0900X
Dermatopathology Physician
GM044698
MI
207NS0135X
Procedural Dermatology Physician
GM044698
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03 000539
PHP OF MICHIGAN
MI
05
—
1622220
—
MI
01
—
GM044698
STATE LICENSE
MI
Enumeration date
05/08/2006
Last updated
03/07/2023
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