Gustav Jaliang Lo, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301053321 Issued in MI

Practice address

116 W Mitchell St
Petoskey, MI 49770-2324

Phone

(231) 348-2828

Fax

(231) 348-9609

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Quick Care Family Medical Center, PC

  • Urgent Care Clinic/Center
  • Petoskey, MI
  • NPI 1841578564
  NPD Authorized official

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1568519635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W MITCHELL ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702324",
            "telephone_number": "231-348-2828",
            "fax_number": "231-348-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W MITCHELL ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702324",
            "telephone_number": "231-348-2828",
            "fax_number": "231-348-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "GUSTAV",
        "middle_name": "JALIANG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301053321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Little Traverse Hearing LLC
• Little Traverse Psychiatric Associates, PC
• Wun Ling Liu
• Liznwes LLC
• Stephanie Llewellyn
• John Lockard, MA, LPC, CAADC
• Phillip Albert Loesch, ATC, CSCS
• Jonathan Lonchar, BS, CADC DP
• Loyal W Jodar MD PC
• Michael John Lucido, LLP

• General Practice Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.