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Individual

FREDY MASONGSONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
27155 CHERRY HILL RD, INKSTER, MI 48141-1204
(313) 749-1178
Mailing address
PO BOX 746723, ATLANTA, GA 30374-6723
(312) 733-9730
(773) 866-8014

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704244001
MI

Other

Enumeration date
05/26/2016
Last updated
02/25/2026
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