Gregory Vanwienen, MD
Family Medicine in Jenison, MI. Individual provider (NPI-1).
NPI number1194771972
StatusActive
Last updated in NPPESDec 28, 2021
Details
- NPI
- 1194771972
- Entity type
- Individual (NPI-1)
- Name
- Gregory Vanwienen
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 25, 2006
- Certification date
- Dec 28, 2021
- Last updated
- Dec 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 4301063899 | MI | Yes |
Practice location
7780 20th AveJenison, MI 49428-8524
Phone 616-685-8700 · Fax 616-457-5567
Mailing address
245 State St SeGrand Rapids, MI 49503-4328
Phone 616-685-1808 · Fax 616-685-1850
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