Healthcare Provider Details

I. General information

NPI: 1902187008
Provider Name (Legal Business Name): WELLHEALTH MEDICAL ASSOCIATES P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2011
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 WALTON BLVD SUITE 212
ROCHESTER MI
48307-6917
US

IV. Provider business mailing address

1202 WALTON BLVD SUITE 212
ROCHESTER MI
48307-6917
US

V. Phone/Fax

Practice location:
  • Phone: 248-650-8383
  • Fax:
Mailing address:
  • Phone: 248-650-8383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: SANJAY MURTHY
Title or Position: PRESIDENT
Credential: MD
Phone: 248-650-8383