Individual
DR. WAYNE TREVOR, J NORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, 12TH FLOOR K BUILDING, DETROIT, MI 48202-2608
(248) 904-8743
Mailing address
2799 W GRAND BLVD, 12TH FLOOR K BUILDING -, DETROIT, MI 48202-2608
(248) 904-8743
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301096246
MI
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
35.125720
OH
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
4301096246
MI
Other
Enumeration date
10/25/2010
Last updated
07/19/2023
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