Individual
MRS. COURTNEY ANN GEARHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
23050 WEST RD, STE 120, BROWNSTOWN TWP, MI 48183-1472
(734) 671-1510
Mailing address
1640 FORT STREET, SUITE D ATTN DENISE, TRENTON, MI 48183
(734) 391-3057
(734) 391-3052
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005870
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28864
BLUE CROSS
MI
01
—
1710315932
GROUP NPI HENRY FORD WYANDOTTE
MI
Enumeration date
09/13/2010
Last updated
02/22/2017
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