Healthcare Provider Details

I. General information

NPI: 1942202486
Provider Name (Legal Business Name): WILLIAM R. TUURI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15200 KERCHEVAL ST
GROSSE POINTE PARK MI
48230-1356
US

IV. Provider business mailing address

PO BOX 77000 DEPARTMENT 771036
DETROIT MI
48277-2000
US

V. Phone/Fax

Practice location:
  • Phone: 313-417-6100
  • Fax: 313-417-6107
Mailing address:
  • Phone: 586-447-4171
  • Fax: 586-447-4180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301406373
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: