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1487250700
FAITH WALID GAMMOUH
DETROIT, MI
NPI
1487250700
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601010551TMP21)
Enumeration Date
2020-12-10
Last Update Date
2021-05-21
Business Address
FAITH WALID GAMMOUH
259 MACK AVE
DETROIT, MI 48201-2427
Phone number: 313-577-1716
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Mailing Address
FAITH WALID GAMMOUH
259 MACK AVE
DETROIT, MI 48201-2427
Phone number: 313-577-1716
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