Individual
JACOB GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1600 S CANTON CENTER RD, SUITE 200, CANTON, MI 48188-6276
(734) 398-7880
(734) 761-7318
Mailing address
24 FRANK LLOYD WHITE DRIVE, SUITE J2000, ANN ARBOR, MI 48105
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301509683
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/24/2020
Last updated
07/03/2023
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