Gravelyn, Thomas R
Gravelyn, Thomas R is an individual health care provider with primary practice located at 5333 Mcauley Dr Suite 3111, Ypsilanti MI 48197-1014. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Gravelyn, Thomas R can be contacted via phone (734) 712-7688.Contact Information
Primary practice address
5333 Mcauley Dr Suite 3111
Ypsilanti MI 48197-1014
Phone: (734) 712-7688
Fax: (734) 712-7056
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | TG044869 | Michigan |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | TG044869 | Michigan |
Profile Details
| NPI number | 1760442636 |
|---|---|
| LBN Legal business name | Gravelyn, Thomas R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Oct 28th, 2015 - about 10 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 | 1760442636 | NPPES |
| Michigan | MEDICAID | 423968610 |
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