Organization
CHARLES B. GOSS, D.O., P.C.
Active
Organization
CHARLES B. GOSS, D.O., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES B. GOSS D.O. (PRESIDENT)
(248) 471-5700
Entity
Organization
Contact information
Practice address
28100 GRAND RIVER AVE, SUITE 102, FARMINGTON HILLS, MI 48336-5967
(248) 471-5700
(248) 851-5515
Mailing address
28100 GRAND RIVER AVE, SUITE 102, FARMINGTON HILLS, MI 48336-5967
(248) 471-5700
(248) 851-5515
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1091313 11 00
—
MI
01
—
260F338480
BLUE CROSS & BLUE SHIELD
MI
Enumeration date
01/02/2007
Last updated
01/25/2008
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