Individual
MARY JANE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, 3RD FLOOR CARDIOVASCULAR CENTER RECP C, ANN ARBOR, MI 48109-5864
(888) 287-1082
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002416
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601002416
MICHIGAN STATE LICENSE
MI
Enumeration date
03/09/2007
Last updated
03/17/2018
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