# WALNUT LAKE OBGYN PLLC

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

## Provider details

- **NPI number:** 1942340187
- **Authorized official:** DR. ALAN D GOLDSMITH MD (PARTNER)
- **Authorized official phone:** (248) 926-2020

## Contact information

- **Practice address:** 2300 HAGGERTY RD, STE 2070, WEST BLOOMFIELD, MI 48323-2184
- **Practice address phone:** (248) 926-2020
- **Practice address fax:** (248) 926-9020
- **Mailing address:** 2300 HAGGERTY RD, STE 2070, WEST BLOOMFIELD, MI 48323-2190
- **Mailing address phone:** (248) 926-2020
- **Mailing address fax:** (248) 926-9020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | AG035173 | MI | Yes |

## Other

- **Enumeration date:** 02/07/2007
- **Last updated:** 06/18/2010