Provider Demographics
NPI:1841288693
Name:PINNELL, GREGORY ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:ARTHUR
Last Name:PINNELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 LAPEER AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1208
Mailing Address - Country:US
Mailing Address - Phone:989-759-6464
Mailing Address - Fax:989-399-8233
Practice Address - Street 1:1522 JANES ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-1819
Practice Address - Country:US
Practice Address - Phone:989-755-0316
Practice Address - Fax:989-755-0956
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075483207Q00000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0090252OtherBCBS PIN
116165OtherGREAT LAKES HEALTH PLAN
MI264OtherCOMMUNITY CHOICE
381908328OtherTRICARE
160050643OtherRAILROAD MEDICARE
381908328OtherFIRST HEALTH
MI0800902521OtherBCBS PIN
MI080G310660OtherBCBS
1010673OtherHEALTH ADVANTAGE PPO
381908328OtherPPOM
MI4686730OtherMOLINA HEALTH CARE
1010673OtherMCLAREN HEALTH PLAN
MI0988680OtherHEALTHPLUS
7323200OtherAETNA
381908328OtherHCAP
MIP109042OtherBLUE CARE NETWORK
1010673OtherHEALTH ADVANTAGE PPO
MI264OtherCOMMUNITY CHOICE
MIMI1566009Medicare UPIN
MI0G36111-087Medicare PIN
381908328OtherHCAP
1010673OtherMCLAREN HEALTH PLAN