Individual
GUDALIA FAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2603 ELECTRIC AVE STE 1, PORT HURON, MI 48060-6588
(810) 987-5252
(810) 987-2120
Mailing address
45640 SCHOENHERR RD, SUITE B, UTICA, MI 48315-6033
(586) 247-4300
(586) 532-6496
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704267837
MI
Other
Enumeration date
11/04/2014
Last updated
02/17/2016
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