Individual
TIFFNEY MONIQUE WIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3901 BEAUBIEN ST, DETROIT, MI 48201-2119
(313) 745-1892
Mailing address
4201 ST. ANTOINE - UHC 5D MAILBOX 226, UNIVERSITY PEDIATRICIANS, DETROIT, MI 48201
(313) 745-4405
(313) 966-0665
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301105422
MI
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
4301105422
MI
Other
Enumeration date
04/04/2014
Last updated
08/02/2017
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