Individual
DR. DOUGLAS ROBERT GRUCZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7330 N CANTON CENTER RD, SUITE 111, CANTON, MI 48187-1538
(734) 454-8001
(734) 454-8030
Mailing address
5952 CENTRALIA ST, DEARBORN HEIGHTS, MI 48127-2933
(313) 300-2783
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301099539
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301099539
LICENSE
MI
Enumeration date
07/21/2011
Last updated
06/17/2014
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