# WILSHIRE OBSTETRIC & GYNECOLOGIC ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477621068
- **Authorized official:** MILLARD R GOLUSIN MD (OWNER PRESIDENT)
- **Authorized official phone:** (248) 267-5040

## Contact information

- **Practice address:** 13467 23 MILE RD, SHELBY TOWNSHIP, MI 48315-2717
- **Practice address phone:** (248) 267-5040
- **Practice address fax:** (248) 267-5041
- **Mailing address:** 13467 23 MILE RD, SHELBY TOWNSHIP, MI 48315-2717
- **Mailing address phone:** (248) 267-5040
- **Mailing address fax:** (248) 267-5041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 4301063722 | MI | — |
| 207V00000X | Obstetrics & Gynecology Physician | 4301077870 | MI | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | MG039013 | MI | — |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 07/18/2013