Bleil, Gordon R

Bleil, Gordon R is an individual health care provider with primary practice located at 955 S Bailey Ave , South Haven MI 49090-9701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bleil, Gordon R can be contacted via phone (269) 639-2910.

Contact Information

Primary practice address
955 S Bailey Ave South Haven MI 49090-9701
Phone: (269) 639-2910
Fax: (269) 639-2919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 056047 Michigan

Profile Details

NPI number 1295847739
LBN Legal business name Bleil, Gordon R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Nov 22nd, 2016 - about 8 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 1295847739 NPPES
Michigan MEDICAID 2937733
Michigan Other 080064237
Michigan Other 0131167
Michigan Other P77691
Michigan Other 5976083
Michigan Other 080H06004

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