Basic Information
| Provider Information | |||||||||
| NPI: | 1497795462 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREGORY | ||||||||
| FirstName: | DIANNE | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SONEFELD | ||||||||
| OtherFirstName: | DIANNE | ||||||||
| OtherMiddleName: | E | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1085 S LINDEN RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485323421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107323240 | ||||||||
| FaxNumber: | 8102300280 | ||||||||
| Practice Location | |||||||||
| Address1: | 8235 HOLLY RD | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | GRAND BLANC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484392441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8106949110 | ||||||||
| FaxNumber: | 8106950343 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301076331 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.