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Individual

DR. MELISA GAGRICA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4201 SAINT ANTOINE ST, SUITE 3R, DETROIT, MI 48201-2153
(313) 745-3000
Mailing address
2457 COY ST, FERNDALE, MI 48220-3420

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
4301082232
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036118494
IL
Enumeration date
07/22/2006
Last updated
09/17/2008
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