Healthcare Provider Details

I. General information

NPI: 1447825831
Provider Name (Legal Business Name): WORKIT HEALTH MI PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 EXECUTIVE DR STE 3
MADISON MS
39110-8497
US

IV. Provider business mailing address

3300 WASHTENAW AVE STE 280
ANN ARBOR MI
48104-5184
US

V. Phone/Fax

Practice location:
  • Phone: 734-373-0849
  • Fax:
Mailing address:
  • Phone: 415-842-9771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY BARKER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 734-373-0849