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Organization
RICHARD A. WANDZEL, DO PC
Active
Organization
RICHARD A. WANDZEL, DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A WANDZEL D.O. (OWNER)
(248) 889-7600
Entity
Organization
Contact information
Practice address
222 W HIGHLAND RD, HIGHLAND, MI 48357-4504
(248) 889-7600
(248) 889-5876
Mailing address
222 W HIGHLAND RD, HIGHLAND, MI 48357-4504
(248) 889-7600
(248) 889-5876
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
5101008319
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040F370330
BCBSM
MI
01
—
0456301784
BLUE CROSS
MI
05
—
1751002
—
MI
Enumeration date
10/21/2008
Last updated
02/10/2010
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