Individual
DR. GABRIEL BAKULA CORVETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5656 W US HIGHWAY 10, LUDINGTON, MI 49431-2454
(231) 843-2543
(231) 843-2547
Mailing address
PO BOX 1847, MUSKEGON, MI 49443-1847
(231) 672-2120
(231) 728-5981
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301500868
MI
2086S0102X
Surgical Critical Care Physician
4301500868
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2013
Last updated
06/19/2020
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