Individual
THOMAS W WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 3RD FLOOR CARDIOVASCULAR CENTER RECP B, ANN ARBOR, MI 48109-5329
(734) 936-5850
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301042329
MI
2086S0102X
Surgical Critical Care Physician
4301042329
MI
2086S0129X
Vascular Surgery Physician
Primary
4301042329
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1592499
—
MI
Enumeration date
09/25/2006
Last updated
03/16/2011
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