Provider Demographics
NPI:1871814095
Name:GORDON SPRATT, ELIZABETH ANNE (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:GORDON SPRATT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1979 HURON PKWY
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4141
Mailing Address - Country:US
Mailing Address - Phone:734-344-4567
Mailing Address - Fax:734-669-1104
Practice Address - Street 1:3333 SPRING ARBOR RD STE 500
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-8605
Practice Address - Country:US
Practice Address - Phone:517-205-2106
Practice Address - Fax:517-205-0125
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2020-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY261792207N00000X
MI4301106750207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology