Individual
DR. MARY E PETTY-DUDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3 HERITAGE DR, SUITE 1, SOUTHGATE, MI 48195-3000
(734) 283-3222
(734) 283-4006
Mailing address
30274 YOUNG DR, GIBRALTAR, MI 48173-9457
(313) 831-8303
(313) 831-8307
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MP058113
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102435
GREAT LAKES
MI
01
—
110825451
BCBS
MI
05
—
4503142 TYPE 10
—
MI
01
—
MP058113
BCBS
MI
Enumeration date
05/30/2006
Last updated
02/12/2026
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