Individual
CASSANDRA WORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2205 JOLLY RD, STE. B, OKEMOS, MI 48864-3983
(517) 347-4085
(517) 347-4170
Mailing address
39465 W 14 MILE RD, NOVI, MI 48377-1600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301072467
MI
207V00000X
Obstetrics & Gynecology Physician
4301072467
MI
208D00000X
General Practice Physician
4301072467
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5199852
—
MI
Enumeration date
07/16/2007
Last updated
11/01/2018
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