Gary Gazella, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

GG034127 Issued in MI

Practice address

8555 N Silvery LN
Suite C302
Dearborn Heights, MI 48127-1379

Phone

(313) 561-0550

Fax

(313) 561-3646

NPI assigned

Jul 15, 2005

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

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1609875392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8555 N SILVERY LN",
            "address_2": "SUITE C302",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271379",
            "telephone_number": "313-561-0550",
            "fax_number": "313-561-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8555 N SILVERY LN",
            "address_2": "SUITE C302",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271379",
            "telephone_number": "313-561-0550",
            "fax_number": "313-561-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZELLA",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "GG034127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5395145",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "125090",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4492586",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "A77142",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Garner
• Latavia Garrett
• Dania Gelan
• Genesis Healthcare
• Genesis MD Diagnostic Imaging PC
• Genesis MD, PLLC
• Gentle Care Dental

• Family Medicine Physician in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.