Individual
MRS. MARY GARRITY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202
(313) 916-2690
(313) 916-2687
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2690
(313) 916-2687
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704259671
MI
364SA2100X
Acute Care Clinical Nurse Specialist
4704259671
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508299686
BCBS
MI
05
—
1508299686
—
MI
Enumeration date
08/13/2013
Last updated
02/18/2021
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