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Individual

GREGORY BERNARD FITZGERALD

Active
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Individual

GREGORY BERNARD FITZGERALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301070156
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
135378
CARE CHOICES ID #
MI
01
14377
M-CARE
MI
01
180F321870
BLUE CROSS GROUP
MI
01
7532354
AETNA
MI
01
G5031F
BLUE CARE NETWORK GROUP #
MI
01
H50483
HAP UPIN
MI
01
H50483
HAP
01
H54083
PPOM UPIN
MI
Enumeration date
06/21/2005
Last updated
11/17/2021
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