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NPI Code Detail

MEDICARE: NATHAN A WLOCH PA

MEDICARE: NATHAN A WLOCH PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601005025MI

General Provider Information

NPI Number : 1356546949
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN A WLOCH PA
Provider Business Mailing Address
First Line : 44201 DEQUINDRE RD
Second Line :
City : TROY
State : MI
Zip : 48085-1117
Country : US
Telephone Number : 248-964-8433
Fax Number : 248-423-2576
Provider Business Practice Location Address
First Line : 44201 DEQUINDRE RD
Second Line :
City : TROY
State : MI
Zip : 48085-1117
Country : US
Telephone Number : 248-964-8433
Fax Number : 248-423-2576
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2007
Last Update Date : 12/12/2025

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Directions to “ NATHAN A WLOCH PA” Practice Location

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