Individual
MARY HATAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5301 E HURON RIVER DR, YPSILANTI, MI 48197-1051
(734) 712-9456
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704146733
MI
Other
Enumeration date
03/20/2007
Last updated
03/08/2019
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