Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | GD000703 | MI |
NPI | 1407855992 |
---|---|
Provider Name | Dr. Gerald Lee Dowling |
First Address | Bay City, MI 48706-2906 |
Second Address | Bay City, MI 48706-2906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 20/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093907669 | BLUE CARE NETWORK ADVANTAGE (01) | MI |
1380728 | (05) | MI |
T33924 | (02) | MI |