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1083019012
GUDALIA FAJARDO
PORT HURON, MI
NPI
1083019012
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MI 4704267837)
Enumeration Date
2014-11-04
Last Update Date
2016-02-17
Business Address
-- GUDALIA FAJARDO
2603 ELECTRIC AVE STE 1
PORT HURON, MI 48060-6588
Phone number: 810-987-5252
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Mailing Address
-- GUDALIA FAJARDO
45640 SCHOENHERR RD SUITE B
UTICA, MI 48315-6033
Phone number: 586-247-4300
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