Individual
DR. LOUIS JEREMY GELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
28460 SOUTHFIELD RD, LATHRUP VILLAGE, MI 48076-2820
(248) 353-0096
(248) 809-6255
Mailing address
28460 SOUTHFIELD RD, LATHRUP VILLAGE, MI 48076-2820
(248) 353-0096
(248) 809-6255
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001926
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101026
GREAT LAKES HEALTH PLAN
MI
01
—
2430677
CIGNA
MI
05
—
4431259
—
MI
01
—
4627620001
DMERC LICENSE NUMBER
MI
01
—
4856352050
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
11/09/2005
Last updated
07/24/2019
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