Provider Demographics
NPI:1710643432
Name:HOWARD, GREGORY Q
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:Q
Last Name:HOWARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18121 E 8 MILE RD STE 318
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3244
Mailing Address - Country:US
Mailing Address - Phone:313-909-3892
Mailing Address - Fax:
Practice Address - Street 1:8132 E BRENTWOOD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-3668
Practice Address - Country:US
Practice Address - Phone:313-909-3892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health