Healthcare Provider Details

I. General information

NPI: 1942467378
Provider Name (Legal Business Name): JOHN W. ARMSTEAD M.D. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 VENOY RD. SUITE 400
WAYNE MI
48184-1891
US

IV. Provider business mailing address

4020 VENOY RD. SUITE 400
WAYNE MI
48184-1891
US

V. Phone/Fax

Practice location:
  • Phone: 734-326-5000
  • Fax: 734-326-0102
Mailing address:
  • Phone: 734-326-5000
  • Fax: 734-326-0102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberJA050190
License Number StateMI

VIII. Authorized Official

Name: JOHN W ARMSTEAD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 734-326-5000