Healthcare Provider Details

I. General information

NPI: 1821255308
Provider Name (Legal Business Name): MEDICAL WELLNESS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23111 E MAIN ST
ARMADA MI
48005-4706
US

IV. Provider business mailing address

PO BOX 479
ARMADA MI
48005-0479
US

V. Phone/Fax

Practice location:
  • Phone: 586-784-9127
  • Fax:
Mailing address:
  • Phone: 586-784-9127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCISCO L BUEN III
Title or Position: FAMILY PHYSICIAN
Credential: MD
Phone: 586-784-9127