# MILLENNIUM MEDICAL GROUP WEST

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WESTLAND CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962590869
- **Authorized official:** MS. CINDY A STRAIGHT (ADMINISTRATOR)
- **Authorized official phone:** (734) 728-2130

## Contact information

- **Practice address:** 6149 N WAYNE RD, BILLING DEPT, WESTLAND, MI 48185-7128
- **Practice address phone:** (734) 728-2130
- **Practice address fax:** (734) 728-2626
- **Mailing address:** 6149 N WAYNE RD, BILLING DEPT, WESTLAND, MI 48185-7128
- **Mailing address phone:** (734) 728-2130
- **Mailing address fax:** (734) 728-2626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 4704144105 | MI | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 08/22/2020