Dr Dietmar J Grentz, MD | |
2725 Airview Blvd, Ste 105, Portage, MI 49002-1803 | |
(269) 349-8386 | |
(269) 349-8397 |
Full Name | Dr Dietmar J Grentz |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 2725 Airview Blvd, Portage, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346269586 | NPI | - | NPPES |
M97310016 | Other | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 39564 (Minnesota) | Secondary |
207Q00000X | Family Medicine | 4301069296 (Michigan) | Primary |
207Q00000X | Family Medicine | 036069689 (Illinois) | Secondary |
Entity Name | Vpa Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336153295 PECOS PAC ID: 9234041948 Enrollment ID: O20031103000102 |
Mailing Address | Practice Location Address |
---|---|
Dr Dietmar J Grentz, MD 7088 Green Timber Ct, Greenville, MI 48838-8193 Ph: (616) 712-6436 | Dr Dietmar J Grentz, MD 2725 Airview Blvd, Ste 105, Portage, MI 49002-1803 Ph: (269) 349-8386 |
Brandon J Manderle, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2700 E Centre Ave, Portage, MI 49002 Phone: 269-286-7050 | |
Carolyn Von Maur, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7901 Angling Road, Suite B-201, Portage, MI 49024 Phone: 269-324-8600 | |
Remnant Mwanahiba, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2700 E Centre Ave, Portage, MI 49002 Phone: 269-286-7050 | |
Dr. Ann M. Busha, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 3300 W Centre Ave, Portage, MI 49024 Phone: 269-324-8950 Fax: 269-324-2134 | |
Amber Darey, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3300 W Centre Ave, Portage, MI 49024 Phone: 269-324-8950 Fax: 269-324-2134 | |
Lawrence Ulmer, Family Medicine Medicare: Medicare Enrolled Practice Location: 7901 Angling Rd, Suite B-201, Portage, MI 49024 Phone: 269-324-8600 Fax: 269-324-8617 | |
Dr. Miriam Yvonne Veldt, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2725 Airview Blvd, Suite 105, Portage, MI 49002 Phone: 269-349-8386 Fax: 269-349-8397 |