Individual
GERALD L LARSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1459 S CENTER RD, BURTON, MI 48509-1726
(810) 496-0900
(810) 742-3891
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
(810) 342-1590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101007523
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3302490
—
MI
01
—
F19561
HAP
MI
Enumeration date
12/13/2005
Last updated
07/08/2007
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