Wyandotte Physician Practices

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WYANDOTTE PHYSICIAN PRACTICES

Practice address

23050 West Rd
Ste 260
Brownstown TWP, MI 48183-1472

Phone

(734) 284-4309

Fax

(734) 671-1405

NPI assigned

Oct 12, 2010

Last updated

Oct 12, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mike Anctil

Title

Administrator, Outpatient Services

Phone

(734) 246-8803

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1286841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286841600000",
    "number": "1679883672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674102",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482674102",
            "telephone_number": "734-284-4309",
            "fax_number": "734-671-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23050 WEST RD",
            "address_2": "STE 260",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831472",
            "telephone_number": "734-284-4309",
            "fax_number": "734-671-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYANDOTTE PHYSICIAN PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-12",
        "last_updated": "2010-10-12",
        "status": "A",
        "authorized_official_last_name": "ANCTIL",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "ADMINISTRATOR, OUTPATIENT SERVICES",
        "authorized_official_telephone_number": "734-246-8803"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Gough Wood, D.O.
• Woodward Detroit CVS, L.L.C. (CVS Pharmacy #08160)
• Debbie D Woody Vitale, DPM
• Siu Hiu Wu, PHARM. D.
• Wyandotte Physician Practices (Downriver Dermatology Center)
• Melissa Wylie, D.O.
• Mariam Shabaan Yasin, PHARMD
• Laal S. Zada, DPM
• Shannon J Ziriada, FNP-BC

• Surgery Physician in Brownstown TWP, MI
• Providers in Brownstown TWP, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; 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.