Provider Demographics
NPI:1336822550
Name:MCGREW, BOBBIE (CRANIAL PROSTHESIS)
Entity Type:Individual
Prefix:MRS
First Name:BOBBIE
Middle Name:
Last Name:MCGREW
Suffix:
Gender:F
Credentials:CRANIAL PROSTHESIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11298 BRYDAN ST APT 236
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3995
Mailing Address - Country:US
Mailing Address - Phone:313-333-8693
Mailing Address - Fax:
Practice Address - Street 1:11298 BRYDAN ST APT 236
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3995
Practice Address - Country:US
Practice Address - Phone:313-333-8693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier