Gradolph, Paul Richard
Gradolph, Paul Richard is an individual health care provider with primary practice located at 43421 Garfield Rd Ste 1, Clinton Twp MI 48038-1133. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gradolph, Paul Richard can be contacted via phone (586) 286-5500.Contact Information
Primary practice address
43421 Garfield Rd Ste 1
Clinton Twp MI 48038-1133
Phone: (586) 286-5500
Fax: (586) 286-0900
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | PG034110 | Michigan |
Profile Details
| NPI number | 1417946815 |
|---|---|
| LBN Legal business name | Gradolph, Paul Richard |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2005 |
| Last updated | Dec 22nd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417946815 | NPPES |
| Michigan | MEDICAID | 4362474 |
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