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Individual

GYPSA KATOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4201 SAINT ANTOINE ST STE 5B, DETROIT, MI 48201-2153
(313) 745-1741
(313) 745-8165
Mailing address
4201 SAINT ANTOINE ST # 5B, DETROIT, MI 48201-2153
(313) 745-1741

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301500191
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4301110120
MI STATE LICENSE
MI
Enumeration date
07/18/2016
Last updated
01/18/2024
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