Male or Other

Gregory M. Mlacker M.D.

Diagnostic Radiology Physician in Grand Rapids, MI(View on Map)

Full Name

Gregory Michael Mlacker M.D.

NPI Number

1205219904

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/30/2015

Specialties

(Taxonomies)

Code

2085R0202X
207R00000X

Primary Taxonomy

Yes
No

Licenses

State

California
Michigan
Michigan

License Number

A166901
4301504388
L801239

Contact
Information

Purpose

Mailing
Location

Address

3264 N EVERGREEN DR NE
3264 N EVERGREEN DR NE

City

Grand Rapids
Grand Rapids

State

MI
MI

Postal Code

49525-9746
49525-9746

Country

US
US

Telephone Number

(616) 363-7272
(616) 363-7272

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/15/2021

Provider Address

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