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Organization

GWENDOLYN WASHINGTON M.D. PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GWENDOLYN WASHINGTON M.D. (PRESIDENT)
(248) 350-8895
Entity
Organization

Contact information

Practice address
29255 NORTHWESTERN HWY STE 105, SOUTHFIELD, MI 48034-5740
(248) 350-8895
(248) 350-8894
Mailing address
29255 NORTHWESTERN HWY STE 105, SOUTHFIELD, MI 48034-5740
(248) 350-8895
(248) 350-8894

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2103295
MI
Enumeration date
01/04/2010
Last updated
01/04/2010
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