Wyandotte Medical Practices

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301063383 Issued in MI

Legal business name

WYANDOTTE MEDICAL PRACTICES

Doing business as

Bariatric Surgery Center

Practice address

3333 Biddle St
Ste C
Wyandotte, MI 48192-6284

Phone

(734) 285-7420

Fax

(734) 285-7386

NPI assigned

Apr 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew Wolocko

Title

Director

Phone

(734) 324-3591

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bariatric Surgery Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226448000000",
    "number": "1124246228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BIDDLE ST",
            "address_2": "STE C",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481926284",
            "telephone_number": "734-285-7420",
            "fax_number": "734-285-7386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BIDDLE ST",
            "address_2": "STE C",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481926284",
            "telephone_number": "734-285-7420",
            "fax_number": "734-285-7386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYANDOTTE MEDICAL PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-11-12",
        "status": "A",
        "authorized_official_last_name": "WOLOCKO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "734-324-3591"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301063383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DD2881",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "020H224840",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bariatric Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Lynn Woolley, M.A. CCC-SLP
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• Wyandotte Family Dental, PLLC
• Wyandotte Hospital Practices
• Wyandotte Internal Medicine Associates
• Wyandotte Medical Practices
• Wyandotte Medical Practices
• Wyandotte Optical,P.C.
• Wyandotte Pharmacy, Inc.
• Wyandotte Pharmacy, Inc.

• Surgery Physician in Wyandotte, MI
• Providers in Wyandotte, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.