Individual
MRS. CATHERINE LYNN GAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
48681 HAYES RD, SUITE 200, SHELBY TOWNSHIP, MI 48315-4403
(586) 799-1212
(586) 799-1210
Mailing address
54220 MAPLE CREEK CT, SHELBY TOWNSHIP, MI 48316-6013
(586) 697-6152
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002698
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1755014270
BCBS OF MICHIGAN
MI
01
—
CG002698
MICHIGAN STATE LICENSE
MI
Enumeration date
05/22/2007
Last updated
03/07/2023
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