Gary Hayes Coller, DO
Individual provider Active NPI General Practice Physician · Zeeland, MI
NPI 1720073794 · NPPES record last updated Mar 10, 2008
Key facts
- NPI
- 1720073794
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 5101007512 (MI)
- Practice address
- 300 S State St
#5
Zeeland, MI 49464-1676 - Phone
- (616) 772-0700
- Fax
- (616) 772-0777
- NPI assigned
- Sep 15, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101007512 | MI | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 5101007512 | MI | Yes |
Addresses
Primary practice location
300 S State St
#5
Zeeland, MI 49464-1676
Mailing address
300 S State St
#5
Zeeland, MI 49464-1676
Phone (616) 772-0700
Other providers in Zeeland, MI
- Taylor Cherry
- Shasta A Choyce
- City on a Hill Ministries
- Brooke Leanne Clifton
- Brittany Marie Cline
- Lilliana G Collins
- Grace Louise Colson
- Abigail Colvin
- Elizabeth Ann Colvin
- Sarah Colvin
All providers in Zeeland, MI · General Practice Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.