Individual
GILBERT A MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1179 EAST PARIS AVE SE STE 100, GRAND RAPIDS, MI 49546-3682
(616) 690-2690
(616) 360-2034
Mailing address
1179 EAST PARIS AVE SE STE 100, GRAND RAPIDS, MI 49546-3682
(616) 690-2690
(616) 360-2034
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
4301062800
MI
2084P0800X
Psychiatry Physician
35-127636
OH
2084P0800X
Psychiatry Physician
Primary
4301062800
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4305173
—
MI
Enumeration date
09/12/2005
Last updated
11/12/2024
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