Individual
JENNILYN WETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30695 LITTLE MACK, SUITE 200, ROSEVILLE, MI 48066
(586) 294-9600
(586) 294-7570
Mailing address
28289 HOOVER RD, WARREN, MI 48093-5436
(248) 585-8218
(248) 585-8266
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
JW054330
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3123069
—
MI
Enumeration date
09/12/2006
Last updated
02/11/2019
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