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Organization
WYANDOTTE MEDICAL PRACTICE
Active
Organization
WYANDOTTE MEDICAL PRACTICE
Active
Other names
Northline Womans Health
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB BUDD (ADMINISTRATOR OUTPATIENT SERVICES)
(734) 246-8803
Entity
Organization
Contact information
Practice address
15675 NORTHLINE RD, SOUTHGATE, MI 48195-2334
(734) 282-3600
(734) 282-3603
Mailing address
15675 NORTHLINE RD, SOUTHGATE, MI 48195-2334
(734) 282-3600
(734) 282-3603
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
12/28/2010
Last updated
09/30/2011
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