Individual
MELANY JEAN WICZOREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
3212 WOODLAND AVE, ROYAL OAK, MI 48073-2358
(810) 300-7980
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01096561A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2022
Last updated
07/08/2025
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