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Individual

JAMES R GILSDORF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 ARNET ST, SUITE 110, YPSILANTI, MI 48198-5753
(734) 483-0404
(734) 481-0844
Mailing address
200 ARNET ST, SUITE 110, YPSILANTI, MI 48198-5753
(734) 483-0404
(734) 481-0844

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301045438
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004109376
AETNA
MI
01
0208110311
BCBSM
MI
01
101875
CARE CHOICE / PREF CHOICE
MI
01
11276974
CAQH PROVIDER NUMBER
MI
05
1970536
MI
01
B48642
UPIN
MI
01
DC6914
RAILROAD MEDICARE
MI
Enumeration date
03/22/2006
Last updated
02/28/2008
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