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Individual

GABRIEL E PEDRAZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-4950
(616) 252-7200
(616) 252-6239
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3243
(616) 252-0260

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301082542
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
4301082542
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4529372
MI
01
CA2184
RAILROAD MEDICARE
MI
Enumeration date
01/19/2006
Last updated
03/17/2018
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