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General NPI Number Information
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NPI Number | 1285183103
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Entity Type | Organization
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Legal Business Name | WEST MICHIGAN GERIATRIC ASSOCIATES, PLLC
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 2050 N HAGGERTY RD STE 260
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City | CANTON
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State | MI
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Zip | 48187-3796
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Country | US
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Telephone | 248-756-3447
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Fax |
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Provider Business Mailing Address
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Address Line | 2050 N HAGGERTY RD STE 100
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City | CANTON
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State | MI
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Zip | 48187-3796
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DAVID MARGOLIS
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Credential | M.D.
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Telephone | 248-756-3447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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