Individual
JOHANNA JACOBA VERWILGHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16815 E JEFFERSON AVE, SUITE 220, GROSSE POINTE, MI 48230-1923
(313) 831-1100
(313) 831-1177
Mailing address
16815 E JEFFERSON AVE, SUITE 220, GROSSE POINTE, MI 48230-1923
(313) 831-1100
(313) 831-1177
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301077528
MI
207RR0500X
Rheumatology Physician
Primary
4301077528
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026068
DMC
MI
01
—
1108235412
BCBS
MI
Enumeration date
06/08/2006
Last updated
02/22/2017
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