Organization
ADVANCED PHYSICAL MEDICINE, P.C.
Active
Other names
Advanced Physical Medicine, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN WILSON M.D. (OWNER)
(586) 563-3300
Entity
Organization
Contact information
Practice address
24345 HARPER AVE, SAINT CLAIR SHORES, MI 48080-1231
(586) 563-3300
(586) 563-3313
Mailing address
24345 HARPER AVE, SAINT CLAIR SHORES, MI 48080-1231
(586) 563-3300
(586) 563-3313
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
SW061846
MI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
SW061846
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000004300A
CAPE HEALTH PLAN
MI
01
—
116625
GREAT LAKES HEALTH PLAN
MI
01
—
131109
CARE CHOICES
MI
01
—
1932129319
DMENSION
MI
01
—
199589
TOTAL HEALTH CARE
MI
01
—
2505012031
BCBSM
MI
05
—
433225010
—
MI
01
—
5112550
AETNA
MI
01
—
540E019050
BCBSM DME
MI
01
—
5614160001
MC NSC
MI
01
—
578264ADV
UNITED HEALTH CARE
MI
01
—
7908612
CIGNA
MI
01
—
QMXPR0031827
MOLINA HEALTH CARE
MI
Enumeration date
07/20/2006
Last updated
07/23/2008
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