Provider Demographics
NPI:1699845644
Name:GRIVEJ, VIOLETA (MD)
Entity Type:Individual
Prefix:
First Name:VIOLETA
Middle Name:
Last Name:GRIVEJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 W AVON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2705
Mailing Address - Country:US
Mailing Address - Phone:246-656-3239
Mailing Address - Fax:248-656-3261
Practice Address - Street 1:873 W AVON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2705
Practice Address - Country:US
Practice Address - Phone:246-656-3239
Practice Address - Fax:248-656-3261
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066417207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3504501Medicaid
MI3504501Medicaid
G87201Medicare UPIN