Basic Information
| Provider Information | |||||||||
| NPI: | 1659541902 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HESHAM E GAYAR, MD, PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RADIATION ONCOLOGY CONSULTANTS, PC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1236 | ||||||||
| Address2: | |||||||||
| City: | GRAND BLANC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484803236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8103423800 | ||||||||
| FaxNumber: | 8103423784 | ||||||||
| Practice Location | |||||||||
| Address1: | 1295 BARRY DRIVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | LAPEER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102455300 | ||||||||
| FaxNumber: | 8102455310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2008 | ||||||||
| LastUpdateDate: | 10/06/2009 | ||||||||
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| AuthorizedOfficialLastName: | KNOPP | ||||||||
| AuthorizedOfficialFirstName: | SUSAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8103423813 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 4301056934 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.