Healthcare Provider Details

I. General information

NPI: 1033073838
Provider Name (Legal Business Name): TING WEN MBBS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD RM 663, MAIN CAMPUS, HENRY FORD HOSPITAL
DETROIT MI
48202-2689
US

IV. Provider business mailing address

2799 W GRAND BLVD
DETROIT MI
48202-2689
US

V. Phone/Fax

Practice location:
  • Phone: 313-428-1779
  • Fax: 313-428-1779
Mailing address:
  • Phone: 313-428-1779
  • Fax: 313-428-1779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZG1000X
TaxonomyMedical Geneticist (PhD) Specialist/Technologist
License Number2025227
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: