Provider Demographics
NPI:1023380797
Name:GELL, LEONARD SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:SAMUEL
Last Name:GELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 PARCHMENT DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8302
Mailing Address - Country:US
Mailing Address - Phone:616-676-9438
Mailing Address - Fax:
Practice Address - Street 1:7650 CONSERVATION ST NE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-9522
Practice Address - Country:US
Practice Address - Phone:616-676-9438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1647957207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology