Provider Demographics
NPI:1689774424
Name:MAKRIS, GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:MAKRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 INVESTMENT DR
Mailing Address - Street 2:STE 300
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6365
Mailing Address - Country:US
Mailing Address - Phone:248-267-5000
Mailing Address - Fax:
Practice Address - Street 1:4600 INVESTMENT DR
Practice Address - Street 2:STE 300
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-6365
Practice Address - Country:US
Practice Address - Phone:248-267-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM07130050Medicare PIN