Organization
WILSHIRE OBSTETRIC & GYNECOLOGIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILLARD R GOLUSIN MD (OWNER PRESIDENT)
(248) 267-5040
Entity
Organization
Contact information
Practice address
13467 23 MILE RD, SHELBY TOWNSHIP, MI 48315-2717
(248) 267-5040
(248) 267-5041
Mailing address
13467 23 MILE RD, SHELBY TOWNSHIP, MI 48315-2717
(248) 267-5040
(248) 267-5041
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
4301063722
MI
207V00000X
Obstetrics & Gynecology Physician
Primary
4301077870
MI
207V00000X
Obstetrics & Gynecology Physician
MG039013
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1288220
—
MI
Enumeration date
12/01/2006
Last updated
07/18/2013
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