Provider Demographics
NPI:1184890311
Name:GARY E HOSEY DPM PC
Entity type:Organization
Organization Name:GARY E HOSEY DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LAPIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-851-4900
Mailing Address - Street 1:64177 VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48095-2580
Mailing Address - Country:US
Mailing Address - Phone:810-329-0800
Mailing Address - Fax:
Practice Address - Street 1:64177 VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48095-2580
Practice Address - Country:US
Practice Address - Phone:810-329-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2755490Medicaid
MI4168510001Medicare NSC
MI2755490Medicaid
MI0N36630Medicare PIN