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Organization

ARIEL WAITZMAN MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ARIEL ANDRE WAITZMAN MD (PHYSICIAN)
(313) 582-8853
Entity
Organization

Contact information

Practice address
15212 MICHIGAN AVE, DEARBORN, MI 48126-3497
(313) 582-8853
(313) 582-6417
Mailing address
15212 MICHIGAN AVE, DEARBORN, MI 48126-3497
(313) 582-8853
(313) 582-6417

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301071017
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0826005
BCBS-MI
MI
05
4329765
MI
Enumeration date
04/28/2008
Last updated
06/04/2008
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