Organization
JOHANNA J VERWILGHEN MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA JACOBA VERWILGHEN MD (OFFICE MANAGER)
(313) 831-1100
Entity
Organization
Contact information
Practice address
4160 JOHN R ST, SUITE 525, DETROIT, MI 48201-2020
(313) 831-1100
(313) 831-1177
Mailing address
4160 JOHN R ST, SUITE 525, DETROIT, MI 48201-2020
(313) 831-1100
(313) 831-1177
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301077528
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108235412
BCBS
MI
Enumeration date
02/19/2008
Last updated
01/14/2013
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