Individual
DR. MICHELLE M GILLIATTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
20905 E 12 MILE RD, STE 100, ROSEVILLE, MI 48066-6501
(586) 772-3500
(586) 772-6540
Mailing address
20905 E 12 MILE RD, STE 100, ROSEVILLE, MI 48066-6501
(586) 772-3500
(586) 772-6540
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002041
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669454013
MEDICARE RAILROAD
MI
05
—
4612236
—
MI
01
—
4855011050
BCBS
MI
Enumeration date
11/18/2005
Last updated
11/18/2022
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