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1710079256

NPI Code Detail

MEDICARE: GERALYN DOSKOCH MD

MEDICARE: GERALYN DOSKOCH MD

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	208M00000X	Hospitalist Physician	4301065473	MI
2	207Q00000X	Family Medicine Physician	4301065473	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	381459366062	OTHER	MI	COMMUNITY CHOICE PIN#
2	4301065473	OTHER	MI	BC LICENSE NUMBER
3	GD065473	OTHER	MI	BLUE SHIELD LICENSE NUM
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710079256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALYN DOSKOCH MD

Provider Business Mailing Address
First Line	:	14705 W UPRIGHT ST
Second Line	:
City	:	CHARLEVOIX
State	:	MI
Zip	:	49720-1949
Country	:	US
Telephone Number	:	231-547-6519
Fax Number	:	231-547-5404

Provider Business Practice Location Address
First Line	:	14705 W UPRIGHT ST
Second Line	:
City	:	CHARLEVOIX
State	:	MI
Zip	:	49720-1949
Country	:	US
Telephone Number	:	231-547-6520
Fax Number	:	231-547-5404

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	11/24/2020

Similar Medicare Providers

1750373437 — DR. EDWARD E NEWCOMB M.D.
Practice Location Address:

14705 W UPRIGHT ST
CHARLEVOIX, MI
49720-1949

Practice Phone: 231-547-1308
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1659363299 — DR. MELODIE R BROWN M.D.
Practice Location Address:

14705 W UPRIGHT ST
CHARLEVOIX, MI
49720-1949

Practice Phone: 231-547-1308
Practice Fax: 231-392-7332

1922090547 — DR. DENNIS M JOY M.D.
Practice Location Address:

14705 W UPRIGHT ST
CHARLEVOIX, MI
49720-1949

Practice Phone: 231-547-1308
Practice Fax: 231-392-7332

1376534495 — ANNA G YOUNG M.D.
Practice Location Address:

14705 W UPRIGHT ST
CHARLEVOIX, MI
49720-1949

Practice Phone: 231-547-8777
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1326124058 — MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Practice Location Address:

14709 W. UPRIGHT STREET
CHARLEVOIX, MI
49720-1949

Practice Phone: 231-547-6519
Practice Fax: 231-547-5404

1558581355 — KATHRYN HELEN FRAKE PA
Practice Location Address:

14705 W UPRIGHT ST
CHARLEVOIX, MI
49720-1949

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Directions to “ GERALYN DOSKOCH MD” Practice Location

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