MEDICARE: GAPS HEALTH IN P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician
3	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1851913719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAPS HEALTH IN P.C.

Provider Business Mailing Address
First Line	:	5319 BETHENY CIR
Second Line	:
City	:	SUPERIOR TWP
State	:	MI
Zip	:	48198-9653
Country	:	US
Telephone Number	:	682-206-3118
Fax Number	:

Provider Business Practice Location Address
First Line	:	5319 BETHENY CIR
Second Line	:
City	:	SUPERIOR TWP
State	:	MI
Zip	:	48198-9653
Country	:	US
Telephone Number	:	682-206-3118
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	JODY HUNTER
Credential	:
Telephone Number	:	734-812-0996

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	05/14/2020

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