Organization
THE WELLNESS PLAN MEDICAL CENTERS
Active
Other names
The Wellness Plan, The Wellness Plan Medical Center- Pontiac
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY V KING (CEO & EXECUTIVE DIRECTOR)
(313) 202-8550
Entity
Organization
Contact information
Practice address
46156 WOODWARD AVE, PONTIAC, MI 48342-5033
(248) 897-0900
(248) 858-6499
Mailing address
7700 2ND AVE, DETROIT, MI 48202-2477
(313) 202-8660
(313) 202-8653
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
122300000X
Dentist
—
—
163WG0000X
General Practice Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235651381
PER WPS
—
01
—
PENDING
PER WPS
MI
Enumeration date
07/11/2017
Last updated
08/13/2020
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