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General NPI Number Information
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NPI Number | 1376171322
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Entity Type | Individual
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Provider Name | MAVIS GAPPY
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Gender | Male
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 27970 ORCHARD LAKE RD STE 2
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3767
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Country | US
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Telephone | 248-432-7013
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Fax |
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Provider Business Mailing Address
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Address Line | 27970 ORCHARD LAKE RD STE 2
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3767
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Country | US
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Telephone | 248-432-7013
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Fax | 248-432-7064
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4301512020
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License Number State | MI
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