Organization Active NPI

Gavin Awerbuch MD PLLC

  • Specialist
  • Saginaw, MI
National Provider Identifier
1003130352
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301405226 Issued in MI
Legal business name
GAVIN AWERBUCH MD PLLC
Practice address
5889 Bay Rd
Suite 104
Saginaw, MI 48604-2540
Phone
(989) 791-7999
Fax
(989) 791-7996
NPI assigned
Mar 16, 2010
Last updated
Mar 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gavin I Awerbuch, MD
Title
Owner
Phone
(989) 791-7999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 4301405226 MI Primary

Addresses

Primary practice location

5889 Bay Rd
Suite 104
Saginaw, MI 48604-2540

Mailing address

5889 Bay Rd
Suite 104
Saginaw, MI 48604-2540
Phone (989) 791-7999

Other identifiers 1

IdentifierTypeStateIssuer
2582817MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1003130352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5889 BAY RD",
            "address_2": "SUITE 104",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042540",
            "telephone_number": "989-791-7999",
            "fax_number": "989-791-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5889 BAY RD",
            "address_2": "SUITE 104",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042540",
            "telephone_number": "989-791-7999",
            "fax_number": "989-791-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAVIN AWERBUCH MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-16",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "AWERBUCH",
        "authorized_official_first_name": "GAVIN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-791-7999",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301405226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2582817",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.