Healthcare Provider Details

I. General information

NPI: 1477590123
Provider Name (Legal Business Name): MARGARET E GILLIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 E HURON RIVER DR EMERGENCY DEPARTMENT BUSINESS OFFICE
ANN ARBOR MI
48106
US

IV. Provider business mailing address

2000 GREEN RD EPMG PC
ANN ARBOR MI
48105-1598
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-3962
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number079617
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: