Individual
JAMES GADD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50258 VAN DYKE AVE, SHELBY TWP, MI 48317-1374
(586) 884-4714
Mailing address
50258 VAN DYKE AVE, SHELBY TWP, MI 48317-1374
(586) 884-4714
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401011692
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
813601247
—
MI
Enumeration date
05/30/2018
Last updated
06/16/2018
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