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Organization

WYANDOTTE PHYSICIAN PRACTICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIKE ANCTIL (ADMINISTRATOR, OUTPATIENT SERVICES)
(734) 246-8803
Entity
Organization

Contact information

Practice address
23050 WEST RD, STE 260, BROWNSTOWN TWP, MI 48183-1472
(734) 284-4309
(734) 671-1405
Mailing address
PO BOX 674102, DETROIT, MI 48267-4102
(734) 284-4309
(734) 671-1405

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
10/12/2010
Last updated
10/12/2010
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