Provider Demographics
NPI:1790955045
Name:HESHAM E GAYAR, MD, PC
Entity Type:Organization
Organization Name:HESHAM E GAYAR, MD, PC
Other - Org Name:RADIATION ONCOLOGY CONSULTANTS, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-342-3813
Mailing Address - Street 1:PO BOX 1236
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48480-3236
Mailing Address - Country:US
Mailing Address - Phone:810-342-3800
Mailing Address - Fax:810-342-3784
Practice Address - Street 1:721 N. SHIAWASSEE STREET
Practice Address - Street 2:SUITE A
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867
Practice Address - Country:US
Practice Address - Phone:989-723-1495
Practice Address - Fax:810-342-3874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056934174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty