Provider Demographics
NPI:1285635367
Name:DOWNER, GREGORY H (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:H
Last Name:DOWNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1250 MERCY DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1881
Mailing Address - Country:US
Mailing Address - Phone:231-733-1912
Mailing Address - Fax:231-737-4603
Practice Address - Street 1:1250 MERCY DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1881
Practice Address - Country:US
Practice Address - Phone:231-733-1912
Practice Address - Fax:231-737-4603
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2014-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301048039207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI382690980OtherTAX ID
MI1816250Medicaid
MIA78514Medicare UPIN
MI382690980OtherTAX ID