Individual
GERALYN DOSKOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14705 W UPRIGHT ST, CHARLEVOIX, MI 49720-1949
(231) 547-6520
(231) 547-5404
Mailing address
14705 W UPRIGHT ST, CHARLEVOIX, MI 49720-1949
(231) 547-6519
(231) 547-5404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301065473
MI
208M00000X
Hospitalist Physician
4301065473
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
381459366062
COMMUNITY CHOICE PIN#
MI
01
—
4301065473
BC LICENSE NUMBER
MI
05
—
4847260
—
MI
01
—
GD065473
BLUE SHIELD LICENSE NUM
MI
Enumeration date
09/29/2006
Last updated
11/24/2020
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