# LIGHTHOUSE MEDICAL CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lighthouse Medical Center PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659520237
- **Authorized official:** DR. WILLIE JAMES PETTIWAY SR. M.D. (MEDICAL DOCTOR)
- **Authorized official phone:** (313) 345-8120

## Contact information

- **Practice address:** 8251 W 8 MILE RD, DETROIT, MI 48221-1195
- **Practice address phone:** (313) 345-8120
- **Practice address fax:** (313) 340-9032
- **Mailing address:** 8251 W 8 MILE RD, DETROIT, MI 48221-1195
- **Mailing address phone:** (313) 345-8120
- **Mailing address fax:** (313) 345-4478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | WPO49323 | MI | Yes |

## Other

- **Enumeration date:** 09/18/2008
- **Last updated:** 01/13/2011