Individual
DR. JODI ANN GANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
32255 NORTHWESTERN HWY, SUITE 130, FARMINGTON HILLS, MI 48334
(248) 723-5880
(248) 723-5889
Mailing address
29992 NORTHWESTERN HWY, SUITE C, FARMINGTON HILLS, MI 48334-3292
(248) 851-1430
(248) 851-5182
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
5101011599
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295785533
—
MI
01
—
130F375610
BLUE CROSS BLUE SHIELD
MI
01
—
700H273300
BLUE SHIELD
MI
Enumeration date
05/10/2006
Last updated
03/02/2015
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