Individual
DR. EDWIN H GULLEKSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-2450
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
(810) 342-1590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301024838
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010B56026
BLUE CROSS BLUE SHIELD
MI
01
—
0253390
BLUE CROSS BLUE SHIELD
MI
Enumeration date
11/23/2005
Last updated
07/08/2007
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