Provider Demographics
NPI:1700915675
Name:SHEMICK, GREGORY PAUL (DC)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:PAUL
Last Name:SHEMICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3264 N ADRIAN HWY
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221
Mailing Address - Country:US
Mailing Address - Phone:517-263-5200
Mailing Address - Fax:517-263-4511
Practice Address - Street 1:3264 N ADRIAN HWY
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221
Practice Address - Country:US
Practice Address - Phone:517-263-5200
Practice Address - Fax:517-263-4511
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0027950Medicare ID - Type Unspecified