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Individual

GERIANNE LYNN MALIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
18325 10 MILE ROAD, SUITE 400, ROSEVILLE, MI 48066-4990
(586) 775-4594
(586) 775-4506
Mailing address
18325 10 MILE ROAD, SUITE 400, ROSEVILLE, MI 48066-4990
(586) 775-4594
(586) 775-4506

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002957
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
065 501 3610
BCBS
MI
Enumeration date
10/12/2006
Last updated
01/21/2009
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