Patera, Gregory Leon

Patera, Gregory Leon is an individual health care provider with primary practice located at 750 E Beltline Ave Ne , Grand Rapids MI 49525-6049. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Patera, Gregory Leon can be contacted via phone (616) 949-2600.

Contact Information

Primary practice address
750 E Beltline Ave Ne Grand Rapids MI 49525-6049
Fax: (616) 954-0213
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901002424 Michigan

Profile Details

NPI number 1245234731
LBN Legal business name Patera, Gregory Leon
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Jun 9th, 2008 - about 16 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 1245234731 NPPES
Michigan Other 900C46507 BCBS
Michigan MEDICAID 4249619 BCBS
Michigan Other 410044294 BCBS

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