Individual provider Active NPI

Gregory Golicz, D.O.

  • Occupational Medicine Physician
  • Wayne, MI
National Provider Identifier
1154451771
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
5101008066 Issued in MI
Practice address
37625 Michigan Ave
FMC-Wayne Medical Dept
Wayne, MI 48184-1070
Phone
(734) 467-0222
Fax
(734) 467-0973
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101008066 MI
Occupational Medicine Physician 2083X0100X 5101008066 MI Primary

Addresses

Primary practice location

37625 Michigan Ave
FMC-Wayne Medical Dept
Wayne, MI 48184-1070

Mailing address

37625 Michigan Ave
FMC-Wayne Medical Dept
Wayne, MI 48184-1070
Phone (734) 467-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101008066MIMDEmergency Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1154451771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37625 MICHIGAN AVE",
            "address_2": "FMC-WAYNE MEDICAL DEPT",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841070",
            "telephone_number": "734-467-0222",
            "fax_number": "734-467-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37625 MICHIGAN AVE",
            "address_2": "FMC-WAYNE MEDICAL DEPT",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841070",
            "telephone_number": "734-467-0222",
            "fax_number": "734-467-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLICZ",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101008066",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MI",
            "license": "5101008066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.