Individual
ALYSIA AMY WIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
3800 WOODWARD AVE APT 802, DETROIT, MI 48201-1981
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301512945
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2020
Last updated
10/15/2024
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