Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 5901000586 | MI |
Y | 222Z00000X | Podiatrist | 5901000586 | MI |
NPI | 1063550606 |
---|---|
Provider Name | David Wesley Gunsberg |
First Address | Flint, MI 48532-3647 |
Second Address | Flint, MI 48532-3647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0992830 | HEALTH PLUS OF MICHIGAN (01) | |
T33957 | (02) |