Provider Demographics
NPI:1336362177
Name:BARAN, GREGORY JOHN (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:JOHN
Last Name:BARAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1087 WOODWIND TRL
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-8978
Mailing Address - Country:US
Mailing Address - Phone:517-339-7946
Mailing Address - Fax:
Practice Address - Street 1:1087 WOODWIND TRL
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8978
Practice Address - Country:US
Practice Address - Phone:517-339-7946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist