Individual
GREG HACKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9100 BROMBACH ST, HAMTRAMCK, MI 48212-3473
(313) 972-9001
(313) 972-9038
Mailing address
2450 MIDVALE ST, BIRMINGHAM, MI 48009-1521
(313) 399-9803
(313) 972-9038
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101011844
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4834332
—
MI
01
—
700F374320
BCBS OF MI
MI
01
—
CA1704-P00278505
RR MEDICARE
MI
Enumeration date
06/28/2006
Last updated
05/08/2013
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