Basic Information
Provider Information
NPI: 1548795230
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUNTHER
FirstName: WILLIAM
MiddleName: TALMADGE
NamePrefix:  
NameSuffix: III
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 26901 BEAUMONT BLVD STE 3D
Address2:  
City: SOUTHFIELD
State: MI
PostalCode: 480333849
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3601 W 13 MILE RD
Address2:  
City: ROYAL OAK
State: MI
PostalCode: 480736712
CountryCode: US
TelephoneNumber: 2488985000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/01/2017
LastUpdateDate: 07/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X5151011325MIY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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