Individual
CANDACE GUMMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31333 SOUTHFIELD RD STE 130, BEVERLY HILLS, MI 48025-5473
(248) 952-9190
(248) 952-9190
Mailing address
17187 SCHAEFER HWY, SUITE 4, DETROIT, MI 48235-4132
(313) 367-2767
(313) 367-2818
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704274496
MI
Other
Enumeration date
02/19/2014
Last updated
04/01/2019
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