Individual
AYANA GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20400 LIVERNOIS AVE, DETROIT, MI 48221-1348
(313) 864-3766
(313) 864-8134
Mailing address
20400 LIVERNOIS AVE, DETROIT, MI 48221-1348
(313) 864-3766
(313) 864-8134
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3706905-01
—
TX
01
—
8GT388
BCBS
—
Enumeration date
03/06/2017
Last updated
02/22/2023
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