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Organization
WYANDOTTE PHYSICIAN PRACTICES
Active
Organization
WYANDOTTE PHYSICIAN PRACTICES
Active
Other names
Downriver Internist PC
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB BUDD (DIRECTOR PHYSICIAN PRACTICES)
(734) 391-3057
Entity
Organization
Contact information
Practice address
15450 NORTHLINE RD STE 101, SOUTHGATE, MI 48195-2490
(734) 224-3679
(734) 287-9926
Mailing address
1640 FORT STREET, SUITE D ATTN DENISE, TRENTON, MI 48183
(734) 391-3057
(734) 391-3052
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301048664
MI
Other
Enumeration date
04/05/2012
Last updated
06/20/2018
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