Individual
MRS. JINCY MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-3711
(313) 343-6862
Mailing address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-3711
(313) 343-6862
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005466
MI
Other
Enumeration date
02/04/2009
Last updated
09/28/2012
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