NPI 1184033128

Gateway Detroiteast

Organisation Health Maintenance Organization Detroit, MI

Practice location

Address: 6309 Mack Ave, Detroit, MI 48207-2302
Phone: (313) 921-4700
Fax: (313) 921-1660

Authorised official

Name: Elizabeth Cichon
Title: Clinical Director
Phone: (313) 331-3435

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 6802072589 (MI)

Other Health Maintenance Organization providers in Michigan →

Registry record

NPI: 1184033128
Entity type: Organization
NPI issued: 4 Aug 2014
Record last updated: 4 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.