Individual
MARISA A BAYUDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
22101 MOROSS RD, DETROIT, MI 48236-2148
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006403
MI
Other
Enumeration date
08/10/2012
Last updated
10/01/2024
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