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Organization
WAYNE MEDICAL CENTER PLLC
Active
Organization
WAYNE MEDICAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MODINI CHINTA LIYANAGE M.D. (PRESIDENT)
(734) 729-5780
Entity
Organization
Contact information
Practice address
1203 S WAYNE RD, WESTLAND, MI 48186-4362
(734) 729-5780
(734) 729-7730
Mailing address
1203 S WAYNE RD, WESTLAND, MI 48186-4362
(734) 729-5780
(734) 729-7730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301074724
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023685
MIDWEST HEALTH PLAN
MI
01
—
139077
CARE CHOICES
MI
01
—
16625
MCARE INDIVIDUAL NUMBER
MI
05
—
4626563
—
MI
01
—
611793200
USPOSTAL WORKMEN COMP
MI
01
—
700H221880
BCBSM GROUP NUMBER
MI
01
—
7589557
AETNA
MI
01
—
H98425
HAP NUMBER
MI
01
—
K583
MCARE GROUP NUMBER
MI
01
—
P00213848
RAILROAD MEDICARE
MI
Enumeration date
04/16/2007
Last updated
02/18/2011
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