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Organization
LIGHTHOUSE MEDICAL CENTER PC
Active
Organization
LIGHTHOUSE MEDICAL CENTER PC
Active
Other names
Lighthouse Medical Center PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIE JAMES PETTIWAY SR. M.D. (MEDICAL DOCTOR)
(313) 345-8120
Entity
Organization
Contact information
Practice address
8251 W 8 MILE RD, DETROIT, MI 48221-1195
(313) 345-8120
(313) 340-9032
Mailing address
8251 W 8 MILE RD, DETROIT, MI 48221-1195
(313) 345-8120
(313) 345-4478
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
WPO49323
MI
Other
Enumeration date
09/18/2008
Last updated
01/13/2011
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