NPIMap

Organization Active NPI

Public Wellness Assistance Inc.

  • Primary Care Clinic/Center
  • Waterford, MI
National Provider Identifier
1154566958
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PUBLIC WELLNESS ASSISTANCE INC.
Practice address
955 W Huron St
Waterford, MI 48328-3727
Phone
(248) 773-2705
Fax
(248) 436-6238
NPI assigned
Dec 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Authorized official

Name
Esteban Dagoberto Marichal
Title
President
Phone
(248) 773-2705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

955 W Huron St
Waterford, MI 48328-3727

Mailing address

5119 Highland Rd Ste 391
Waterford, MI 48327-1915
Phone (248) 773-2705

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1154566958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5119 HIGHLAND RD STE 391",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271915",
            "telephone_number": "248-773-2705",
            "fax_number": "248-436-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W HURON ST",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283727",
            "telephone_number": "248-773-2705",
            "fax_number": "248-436-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC WELLNESS ASSISTANCE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "MARICHAL",
        "authorized_official_first_name": "ESTEBAN",
        "authorized_official_middle_name": "DAGOBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-773-2705"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.