Provider Demographics
NPI:1558314005
Name:STREFF, GREGORY J (DO)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:J
Last Name:STREFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9450 S SAGINAW RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8206
Mailing Address - Country:US
Mailing Address - Phone:810-695-4000
Mailing Address - Fax:810-695-4055
Practice Address - Street 1:9450 S SAGINAW RD
Practice Address - Street 2:SUITE E
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8206
Practice Address - Country:US
Practice Address - Phone:810-695-4000
Practice Address - Fax:810-695-4055
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101008684207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIC4234OtherMCARE
MI0152500505OtherHEALTHPLUS
MI103OtherCOMMUNITY CHOICE
MI3361051Medicaid
E50073Medicare UPIN
MIC4234OtherMCARE