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Individual

GORDON KALO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
200 HEMLOCK ST, TAWAS CITY, MI 48763-9237
(989) 362-0153
(989) 362-4683
Mailing address
2393 SCHUST RD, SAGINAW, MI 48603-1334
(989) 793-2820
(989) 755-1463

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704120512
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4096233
MI
05
C56007027
MI
Enumeration date
12/05/2005
Last updated
02/28/2018
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