Individual
DR. TANYA RENEE WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1428 S LAPEER RD, LAKE ORION, MI 48360-1437
(248) 693-0543
Mailing address
PO BOX 2137, BIRMINGHAM, MI 48012-2137
(248) 693-0543
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301086589
MI
Other
Enumeration date
08/31/2009
Last updated
10/02/2012
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