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Individual

DR. S. ELENA GIMENEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5333 MCAULEY DR, STE 3001, YPSILANTI, MI 48197-1014
(734) 712-8100
(734) 712-8111
Mailing address
24 FRANK LLOYD WRIGHT DR, PO BOX 0446 LOBBY J, ANN ARBOR, MI 48105-9484
(734) 747-6766
(734) 222-3100

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
25MA08908300
NJ
208800000X
Urology Physician
Primary
4301102635
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
228676ZASE
MEDICARE ID
NJ
Enumeration date
05/21/2008
Last updated
01/11/2016
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