Provider Demographics
NPI:1851375745
Name:NORTH, GREGORY GUY (PHD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:GUY
Last Name:NORTH
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:5989 S SCHOMBERG RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR
Mailing Address - State:MI
Mailing Address - Zip Code:49621-9703
Mailing Address - Country:US
Mailing Address - Phone:231-933-4268
Mailing Address - Fax:231-269-4461
Practice Address - Street 1:11293 N M-37
Practice Address - Street 2:SUITE A
Practice Address - City:BUCKLEY
Practice Address - State:MI
Practice Address - Zip Code:49620-0001
Practice Address - Country:US
Practice Address - Phone:231-933-4268
Practice Address - Fax:231-269-4461
Is Sole Proprietor?:No
Enumeration Date:2005-12-03
Last Update Date:2019-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI63010005865103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI382935998OtherMAGELLAN BEHAVIORAL HEALT
MI038901OtherVALUE OPTIONS
MI11284829OtherCAQH
MI382935998OtherPRIORITY HEALTH
MI382935998OtherTRICARE