Mary Therese Aubrey, PA-C

Individual provider Active NPI Physician Assistant · Oak Park, MI

NPI 1508102922 · NPPES record last updated Dec 13, 2012

Key facts

NPI
1508102922
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
5601006487 (MI)
Practice address
25900 Greenfield Rd Ste 600
Oak Park, MI 48237-1267
Phone
(248) 967-8751
NPI assigned
Dec 13, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006487 MI Yes

Addresses

Primary practice location

25900 Greenfield Rd Ste 600
Oak Park, MI 48237-1267

Mailing address

7345 Chula Vista LN
Bloomfield Hills, MI 48301-3917
Phone (313) 570-7094

Other providers in Oak Park, MI

All providers in Oak Park, MI · Physician Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.