Individual provider · Type 1 NPI

Agustin Felipe Gavidia Rosario, MD

Student in an Organized Health Care Education/Training Program · Detroit, MI

NPI number 1588403174 Active

Practice location

2799 W Grand Blvd
Detroit, MI 48202

Call (313) 916-2600 Map

Mailing address

Calle Los Sauces 377 Apt 501, San Isidro
Lima, LIMA 15073

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1588403174

Agustin Felipe Gavidia Rosario, MD's National Provider Identifier is 1588403174, issued on May 22, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Detroit, MI. The record was last updated on Sep 17, 2024.