Provider Demographics
NPI:1821203274
Name:NORRIS, GREGORY M (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:M
Last Name:NORRIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-5700
Mailing Address - Fax:810-342-5545
Practice Address - Street 1:4201 SAINT ANTOINE ST
Practice Address - Street 2:SUITE 8A
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-745-4275
Practice Address - Fax:313-745-4468
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2019-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010804612084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P30630505Medicare PIN