Organization
GENESYS INTEGRATED GROUP PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL GARSON (CHIEF FINANCIAL OFFICER)
(810) 424-2025
Entity
Organization
Contact information
Practice address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2007
(810) 232-2266
Mailing address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2007
(810) 743-1099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700B510070
GIGP BCBS GROUP NUMBER
MI
Enumeration date
05/09/2006
Last updated
10/19/2018
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