Provider Demographics
NPI:1164469656
Name:PILAT, MARY JOSEPHINE (PA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JOSEPHINE
Last Name:PILAT
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1420 STEPHENSON HWY
Mailing Address - Street 2:SUITE 400- CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1189
Mailing Address - Country:US
Mailing Address - Phone:248-581-5977
Mailing Address - Fax:248-581-5640
Practice Address - Street 1:KARMANOS CANCER CENTER
Practice Address - Street 2:4100 JOHN R
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2014-01-08
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Provider Licenses
StateLicense IDTaxonomies
MI5601003611363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical