Individual provider · Type 1 NPI

Gary Famiglietti, PA-C

Medical Physician Assistant · Detroit, MI

NPI number 1417076316 Active

Practice location

1560 E Maple Rd, Suite 400 - Credentialing Department
Detroit, MI 48201-2013

Call (800) 527-6266 Map

Fax (313) 576-8381

Mailing address

4100 John R St
Detroit, MI 48201-2013

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X5601001499 (MI)

Medical Physician Assistant: Definition to come...

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About NPI 1417076316

Gary Famiglietti, PA-C's National Provider Identifier is 1417076316, issued on Mar 29, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Detroit, MI. The record was last updated on Feb 27, 2017.