Individual
DR. DOUGLAS JAMES GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000
(231) 346-6017
Mailing address
PO BOX 27127, LANSING, MI 48909-7127
(231) 346-6800
(231) 346-6017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301076105
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0531024
BLUE CROSS BLUE SHIELD
MI
05
—
4522344
—
MI
Enumeration date
09/02/2005
Last updated
11/25/2022
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