Healthcare Provider Details

I. General information

NPI: 1649467523
Provider Name (Legal Business Name): JAMES A GELS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 11/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14730 PARK AVE
CHARLEVOIX MI
49720-1939
US

IV. Provider business mailing address

14730 PARK AVE
CHARLEVOIX MI
49720-1939
US

V. Phone/Fax

Practice location:
  • Phone: 231-547-4439
  • Fax: 231-547-0069
Mailing address:
  • Phone: 231-547-4439
  • Fax: 231-547-0069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301032818
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: