Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | GM001038 | MI |
Y | 222Z00000X | Podiatrist | GM001038 | MI |
NPI | 1043499338 |
---|---|
Provider Name | Dr. Gary Mark Felhandler |
First Address | Monroe, MI 48162-3193 |
Second Address | Monroe, MI 48162-3193 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2007 |
Last Update Date | 02/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1443514 | (05) | MI |
GF001038 | STATE LICENSE NUMBER (01) | MI |
T31433 | (02) | MI |
T34133 | HEALTH ALLIANCE PLAN (01) | MI |