Individual
DR. GILBERT RUSSELL LADD IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3290 W BIG BEAVER RD STE 509, TROY, MI 48084-2917
(248) 290-2220
(248) 290-4019
Mailing address
3290 W BIG BEAVER RD STE 509, TROY, MI 48084-2917
(248) 290-2220
(248) 290-4019
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
GL073196
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38-3513013
TAX ID#
MI
Enumeration date
10/04/2006
Last updated
09/26/2009
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