Individual
MAEGEN MANDEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5130 COOLIDGE HWY, ROYAL OAK, MI 48073-1001
(248) 288-9500
(248) 288-0044
Mailing address
5130 COOLIDGE HWY, ROYAL OAK, MI 48073-1001
(248) 288-9500
(248) 288-0044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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