Provider Demographics
NPI:1205826427
Name:NOWINSKI, GREGORY P (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:P
Last Name:NOWINSKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1350 KIRTS BLVD
Mailing Address - Street 2:STE 160
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4851
Mailing Address - Country:US
Mailing Address - Phone:248-244-9426
Mailing Address - Fax:248-244-9495
Practice Address - Street 1:1350 KIRTS BLVD
Practice Address - Street 2:STE 160
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4851
Practice Address - Country:US
Practice Address - Phone:248-244-9426
Practice Address - Fax:248-244-9495
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2020-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301052623207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3055530Medicaid
MIF67326Medicare UPIN
MI3055530Medicaid