Healthcare Provider Details

I. General information

NPI: 1518662642
Provider Name (Legal Business Name): MANPAL SINGH GILL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 W GRAND RIVER AVE
HOWELL MI
48843-1980
US

IV. Provider business mailing address

400 E RIVULON BLVD STE 103
GILBERT AZ
85297-0096
US

V. Phone/Fax

Practice location:
  • Phone: 517-548-1900
  • Fax:
Mailing address:
  • Phone: 734-788-4402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5151016087
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: