Organization
WALNUT LAKE OBGYN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN D GOLDSMITH MD (PARTNER)
(248) 926-2020
Entity
Organization
Contact information
Practice address
2300 HAGGERTY RD, STE 2070, WEST BLOOMFIELD, MI 48323-2184
(248) 926-2020
(248) 926-9020
Mailing address
2300 HAGGERTY RD, STE 2070, WEST BLOOMFIELD, MI 48323-2190
(248) 926-2020
(248) 926-9020
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
AG035173
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1600F321780
BLUE CROSS GROUP PIN
MI
01
—
1942340187
NPI
MI
Enumeration date
02/07/2007
Last updated
06/18/2010
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