Provider Demographics
NPI:1417974312
Name:HOWARD GREGG JR DO PC
Entity Type:Organization
Organization Name:HOWARD GREGG JR DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:GREGG
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:231-876-7200
Mailing Address - Street 1:400 HOBART ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-2331
Mailing Address - Country:US
Mailing Address - Phone:231-876-7200
Mailing Address - Fax:
Practice Address - Street 1:400 HOBART ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2331
Practice Address - Country:US
Practice Address - Phone:231-876-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104188OtherPREFERRED CHOICES
MI103401OtherMOLINA HEALTHCARE
MI37020OtherCOMMUNITY CHOICE OF MI
MI0H31011OtherBLUE CROSS BLUE SHIELD MI
MIXX27481OtherHEALTHPLUS OF MI
MICI8966OtherRAILROAD MEDICARE
MI15098OtherPRIORITY HEALTH
MI104188OtherPREFERRED CHOICES