1831622794 NPI number — HESHAM E GAYAR, MD, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831622794 NPI number — HESHAM E GAYAR, MD, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HESHAM E GAYAR, MD, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831622794
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4100 BEECHER RD STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48532-3661
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-342-3813
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 W GREENLAWN AVE
Provider Second Line Business Practice Location Address:
RADIATION DEPT
Provider Business Practice Location Address City Name:
LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48910-2819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-975-7800
Provider Business Practice Location Address Fax Number:
810-342-3784
Provider Enumeration Date:
04/07/2017

Additional Information

Authorized Official

Authorized Official Last Name:
KNOPP
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
810-342-3813

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  4301056934 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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