Organization
DETROIT MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILHELMINE WIESE (M.D)
(313) 745-3862
Entity
Organization
Contact information
Practice address
4201 ST ANTOINE, DETROIT, MI 48201
(313) 745-3862
Mailing address
4201ST ANTOINE, DETROIT, MI 48201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L1127555
MI
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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