Individual
DEANGELO WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
375 EUREKA RD STE B, WYANDOTTE, MI 48192
(734) 225-9300
Mailing address
17197 N LAUREL PARK DR STE 107, LIVONIA, MI 48152-7910
(734) 338-8300
(734) 237-5405
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601002997
MI
363AS0400X
Surgical Physician Assistant
Primary
5601002997
MI
Other
Enumeration date
07/24/2006
Last updated
04/17/2019
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