Individual
AGUSTIN FELIPE GAVIDIA ROSARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202
(313) 916-2600
Mailing address
CALLE LOS SAUCES 377 APT 501, SAN ISIDRO, LIMA, LIMA 15073
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/22/2024
Last updated
09/17/2024
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