Provider Demographics
NPI:1649467523
Name:GELS, JAMES A (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:GELS
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 1:14730 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLEVOIX
Mailing Address - State:MI
Mailing Address - Zip Code:49720-1939
Mailing Address - Country:US
Mailing Address - Phone:231-547-4439
Mailing Address - Fax:231-547-0069
Practice Address - Street 1:14730 PARK AVE
Practice Address - Street 2:
Practice Address - City:CHARLEVOIX
Practice Address - State:MI
Practice Address - Zip Code:49720-1939
Practice Address - Country:US
Practice Address - Phone:231-547-4439
Practice Address - Fax:231-547-0069
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301032818207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0150544OtherBLUE CROSS BLUE SHIELD
MI1081827Medicaid
112058607OtherMEDICARE ID TYPE UNSPECIFIED
MI1081827Medicaid
MI0150544OtherBLUE CROSS BLUE SHIELD