Organization Name: | GRATIOT MEDICAL CENTER |
NPI Number: | 1477654234 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK A SANTAMARIA (PRESIDENT/CEO) |
Mailing Address: | 224 N Mill St Saint Louis |
State: | MI US |
Postal Code: | 488801523 |
Phone Number: | 9896813524 |
Fax Number: | 9896812683 |
NPI Enumeration Date: | 09/26/2006 |
NPI Last Update Date: | 01/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |