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Individual

GARRETT L WALWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-6064
(248) 898-5490
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
(947) 522-1859
(947) 522-0307

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301076072
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4740737
MI
Enumeration date
06/30/2006
Last updated
09/10/2019
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