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General NPI Number Information
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NPI Number | 1174824643
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Entity Type | Organization
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Legal Business Name | WOLVERINE STATE INPATIENT SERVICES, PLLC
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 07/05/2013
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Provider Practice Location Address
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Address Line | 703 N MCEWAN ST
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City | CLARE
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State | MI
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Zip | 48617-1440
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Country | US
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Telephone | 214-712-2472
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Fax | 214-712-2444
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Provider Business Mailing Address
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Address Line | 815 S PALAFOX ST 300
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City | PENSACOLA
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State | FL
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Zip | 32502-5960
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Country | US
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Telephone | 800-444-7009
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Fax | 800-305-3233
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Authorized Official
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Title or Position | PRESIDENT
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Name | DOUGLAS WEBSTER
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Credential | DO
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Telephone | 214-712-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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