Individual
MRS. ABBY MARIE WATERFIELD-BOGDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
15855 19 MILE RD, EMERGENCY DEPARTMENT, CLINTON TOWNSHIP, MI 48038-3504
(586) 263-2601
(586) 263-2589
Mailing address
38935 ANN ARBOR RD, CREDENTIALING DEPARTMENT, LIVONIA, MI 48150-3397
(734) 632-0175
(866) 250-6385
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101017479
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12282263
CAQH
—
Enumeration date
07/13/2007
Last updated
01/19/2016
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