Groeneveld, John Ray

Groeneveld, John Ray is an individual health care provider with primary practice located at 440 Woodward Ave , Iron Mountain MI 49801-4631. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Groeneveld, John Ray can be contacted via phone (906) 776-9040.

Contact Information

Primary practice address
440 Woodward Ave Iron Mountain MI 49801-4631
Phone: (906) 776-9040
Fax: (906) 774-7279
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 406754 Michigan

Profile Details

NPI number 1467452391
LBN Legal business name Groeneveld, John Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Mar 17th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467452391 NPPES
Michigan MEDICAID 1994486
Michigan MEDICAID 31491800
Michigan Other P01692639

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