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General NPI Number Information
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NPI Number | 1699949479
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Entity Type | Organization
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Legal Business Name | DR. WENDY MCKAY P.C. DBA SPRINGWELLS CLINIC
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 2117 SPRINGWELLS ST
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City | DETROIT
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State | MI
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Zip | 48209-1507
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Country | US
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Telephone | 313-842-1800
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Fax | 313-842-0600
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Provider Business Mailing Address
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Address Line | 2117 SPRINGWELLS ST
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City | DETROIT
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State | MI
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Zip | 48209-1507
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Country | US
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Telephone | 313-842-1800
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Fax | 313-842-0600
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Authorized Official
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Title or Position | OWNER
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Name | DR. WENDY YOUSIF MCKAY
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Credential | M.D.
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Telephone | 313-842-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 4301045701
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License Number State | MI
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