Provider Demographics
NPI:1235191222
Name:GILL, STEVEN PAUL (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:GILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E GRAND RIVER AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1983
Mailing Address - Country:US
Mailing Address - Phone:810-227-2400
Mailing Address - Fax:810-360-0717
Practice Address - Street 1:600 E GRAND RIVER AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1983
Practice Address - Country:US
Practice Address - Phone:810-227-2400
Practice Address - Fax:810-360-0717
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP25675FOtherBCN OF MICHIGAN
MI950D710560OtherBCBS OF MICHIGAN
MI7365143OtherAETNA
MI0N94770Medicare UPIN