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Individual

MARY BOAYUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P. A.

Contact information

Practice address
29240 BUCKINGHAM ST, LIVONIA, MI 48154
(734) 513-2800
Mailing address
29240 BUCKINGHAM ST, LIVONIA, MI 48154-4575
(734) 513-2800

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007125
MI
363AM0700X
Medical Physician Assistant
5601007125
MI

Other

Enumeration date
08/20/2015
Last updated
05/24/2018
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