MEDICARE: DR. GERALD GOLD D.P.M.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	001648	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568432151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD GOLD D.P.M.

Provider Business Mailing Address
First Line	:	3206 ORCHARD LAKE RD
Second Line	:
City	:	ORCHARD LAKE
State	:	MI
Zip	:	48324-1633
Country	:	US
Telephone Number	:	248-682-6662
Fax Number	:	248-682-2850

Provider Business Practice Location Address
First Line	:	3206 ORCHARD LAKE RD
Second Line	:
City	:	ORCHARD LAKE
State	:	MI
Zip	:	48324-1633
Country	:	US
Telephone Number	:	248-682-6662
Fax Number	:	248-682-2850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	04/15/2008

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