Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | L1647957 | MI |
NPI | 1023380797 |
---|---|
Provider Name | Dr. Leonard Samuel Gell |
First Address | Grand Rapids, MI 49546-8302 |
Second Address | Ada, MI 49301-9522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2012 |
Last Update Date | 27/01/2012 |