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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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