Individual
MRS. ELISSA MARY RIDGEWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
2799 W GRAND BLVD, DEPARTMENT OF SURGERY, DETROIT, MI 48202-2608
(313) 916-3037
Mailing address
2799 W GRAND BLVD, DEPARTMENT OF SURGERY, DETROIT, MI 48202-2608
(313) 916-3037
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004581
MI
Other
Enumeration date
04/16/2007
Last updated
02/19/2021
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