Individual
MAVIS GAISIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-0413
Mailing address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-0413
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4351049426
MI
Other
Enumeration date
04/22/2022
Last updated
04/20/2026
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