Organization
ADVANCED PHYSICAL MEDICINE, P.C.
Active
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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