Basic Information
| Provider Information | |||||||||
| NPI: | 1043314164 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GONTE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | STUART | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29877 TELEGRAPH RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480347659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483540730 | ||||||||
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| Practice Location | |||||||||
| Address1: | 29877 TELEGRAPH | ||||||||
| Address2: | STE 401 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483540730 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2006 | ||||||||
| LastUpdateDate: | 09/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | 4301406796 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207RS0010X | 4301406796 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Sports Medicine |
No ID Information.