Individual
DR. GARY A SHINTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
400 HOBART ST, CADILLAC, MI 49601-2331
(231) 876-7200
(231) 876-6830
Mailing address
PO BOX 6545, TRAVERSE CITY, MI 49696-6545
(231) 922-9270
(231) 922-9271
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101013542
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H310180
BC BILLING NUMBER
MI
01
—
127835
PREF CHOICE BILLING NUMBE
MI
01
—
27544
PRIORITY HEALTH
MI
01
—
383552631057
COMM CHOICE BILLING NUMBE
MI
01
—
4236844
MOLINA
MI
05
—
4236844
—
MI
Enumeration date
08/01/2005
Last updated
10/12/2012
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