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General NPI Number Information
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NPI Number | 1861468845
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Entity Type | Individual
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Provider Name | ANNETTE SASSIN GILMER M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 3350 GRATIOT BLVD
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City | MARYSVILLE
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State | MI
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Zip | 48040-2121
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Country | US
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Telephone | 810-364-4000
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Fax | 810-364-5995
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Provider Business Mailing Address
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Address Line | 7628 YAGER RD
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City | WALES
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State | MI
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Zip | 48027-4506
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Country | US
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Telephone | 810-300-7588
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301051181
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License Number State | MI
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