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Individual

DR. SEAN S WALCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
33155 ANNAPOLIS ST, WAYNE, MI 48184-2405
(734) 467-4000
Mailing address
PO BOX 638257, CINCINNATI, OH 45263-8257
(888) 952-6772
(856) 694-5179

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301078051
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10-4631349
MI
05
10-4631358
MI
05
10-4631376
MI
05
10-4631385
MI
05
10-4631394
MI
05
10-4710335
MI
05
10-4710344
MI
05
10-4710353
MI
01
11311888
CAQH
MI
Enumeration date
01/09/2006
Last updated
07/22/2025
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