Gerondale, Brian J
Gerondale, Brian J is an individual health care provider with primary practice located at 1740 E Paris Ave Se , Grand Rapids MI 49546-6204. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Gerondale, Brian J can be contacted via phone (616) 949-5600.Contact Information
Primary practice address
1740 E Paris Ave Se
Grand Rapids MI 49546-6204
Phone: (616) 949-5600
Fax: (616) 949-6571
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 4301076576 | Michigan |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 4301076576 | Michigan |
Profile Details
| NPI number | 1548250509 |
|---|---|
| LBN Legal business name | Gerondale, Brian J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2005 |
| Last updated | Aug 28th, 2026 - about 3 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548250509 | NPPES |
| Michigan | Other | BG076576 | STATE LICENSE |
| Michigan | Other | 0704110141 | STATE LICENSE |
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