Healthcare Provider Details

I. General information

NPI: 1225972979
Provider Name (Legal Business Name): GENTLEPATH MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2081 ANOKA ST
FLINT MI
48532-4512
US

IV. Provider business mailing address

2081 ANOKA ST
FLINT MI
48532-4512
US

V. Phone/Fax

Practice location:
  • Phone: 312-522-3446
  • Fax:
Mailing address:
  • Phone: 312-522-3446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTINS EFOSA BAZUAYE
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 312-552-3446