Individual
GADA SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10786 PINE ST, TAYLOR, MI 48180-3440
(313) 379-6758
Mailing address
10786 PINE ST, TAYLOR, MI 48180-3440
(313) 379-6758
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
IATRX
MI
Enumeration date
10/07/2020
Last updated
10/07/2020
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