Individual
WILLIAM R BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
30626 FORD RD, GARDEN CITY, MI 48135-1870
(734) 261-9211
(734) 261-8537
Mailing address
30626 FORD RD, GARDEN CITY, MI 48135-1870
(734) 261-9211
(734) 261-8537
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
WB006125
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4591495
—
MI
Enumeration date
07/05/2006
Last updated
04/07/2011
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