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NPI Code Detail

MEDICARE: ANN R GILLETT-ELRINGTON M.D.

MEDICARE: ANN R GILLETT-ELRINGTON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083A0300XAddiction Medicine (Preventive Medicine) Physician4301072747MI
2207V00000XObstetrics & Gynecology Physician4301072747MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AG072747OTHERMIBCBS OF MICHIGAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104856897
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN R GILLETT-ELRINGTON M.D.
Provider Business Mailing Address
First Line : 3516 IRENE ST
Second Line :
City : INKSTER
State : MI
Zip : 48141-2127
Country : US
Telephone Number : 313-421-6794
Fax Number :
Provider Business Practice Location Address
First Line : 2700 HAMLIN BLVD
Second Line :
City : INKSTER
State : MI
Zip : 48141-2206
Country : US
Telephone Number : 313-561-5100
Fax Number : 313-565-0309
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 05/24/2023

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Directions to “ ANN R GILLETT-ELRINGTON M.D.” Practice Location

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