Individual
MELISSA BETH CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601008180
MI
363AM0700X
Medical Physician Assistant
5601008180
MI
363AS0400X
Surgical Physician Assistant
Primary
5601008180
MI
Other
Enumeration date
05/02/2017
Last updated
05/08/2021
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