Larson, Gerald L

Larson, Gerald L is an individual health care provider with primary practice located at 1459 S Center Rd , Burton MI 48509-1726. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Larson, Gerald L can be contacted via phone (810) 496-0900.

Contact Information

Primary practice address
1459 S Center Rd Burton MI 48509-1726
Fax: (810) 742-3891
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101007523 Michigan

Profile Details

NPI number 1891770947
LBN Legal business name Larson, Gerald L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Jul 8th, 2007 - about 19 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891770947 NPPES
Michigan Other F19561 HAP
Michigan Other F19561 HAP
Michigan MEDICAID 3302490 HAP

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