Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 4301096038 | MI |
NPI | 1013235159 |
---|---|
Provider Name | Kyle Gilde |
First Address | Mt Pleasant, MI 48858-3257 |
Second Address | Mt Pleasant, MI 48858-3257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2010 |
Last Update Date | 20/11/2014 |