Individual
DR. JOSEPH GORDON EDELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
560 W MITCHELL ST STE M40, PETOSKEY, MI 49770-2278
(231) 487-3637
(231) 487-6513
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
29735
SC
207RG0100X
Gastroenterology Physician
Primary
4301114320
MI
207RG0100X
Gastroenterology Physician
51996
CO
207RG0100X
Gastroenterology Physician
MD2018-0675
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598766255
—
MI
05
—
297351
—
SC
Enumeration date
08/03/2005
Last updated
11/12/2024
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