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