Provider Demographics
NPI:1073114922
Name:GREGORY E STEMPKY DO PLC
Entity Type:Organization
Organization Name:GREGORY E STEMPKY DO PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:STEMPKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:616-296-2062
Mailing Address - Street 1:17202 VAN WAGONER RD
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-9702
Mailing Address - Country:US
Mailing Address - Phone:616-296-2062
Mailing Address - Fax:616-296-2078
Practice Address - Street 1:17202 VAN WAGONER RD
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-9702
Practice Address - Country:US
Practice Address - Phone:616-296-2062
Practice Address - Fax:616-296-2078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty