Provider Demographics
NPI:1093907669
Name:GERALD L DOWLING DPM PC
Entity Type:Organization
Organization Name:GERALD L DOWLING DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:989-686-2331
Mailing Address - Street 1:316 S COLUMBIAN ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2906
Mailing Address - Country:US
Mailing Address - Phone:989-686-2331
Mailing Address - Fax:989-686-4493
Practice Address - Street 1:316 S COLUMBIAN ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2906
Practice Address - Country:US
Practice Address - Phone:989-686-2331
Practice Address - Fax:989-686-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIGD000703213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1380728Medicaid
MI4850954660OtherBLUE CROSS BLUE SHIELD OF
MION35450Medicare PIN
MI4850954660OtherBLUE CROSS BLUE SHIELD OF
MI0542410001Medicare NSC
MI1093907669Medicare NSC