Doctor Name: | GREGORY POULIOT |
NPI Number: | 1336549328 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 6301016010 |
Business Practice Address: | G3230 Beecher Rd Suite 1 Flint, MI - 485323604 |
Business Phone Number: | 8103425620 |
Business Fax Number: | 8103425629 |
Mailing Address: | 401 S Ballenger Hwy, FLINT |
State: | MI |
Postal Code: | 485323638 |
Phone Number: | 8103421009 |
Fax Number: | 8103421590 |
NPI Enumeration Date: | 08/27/2014 |
NPI Last Update Date: | 08/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 6301016010 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |