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General NPI Number Information
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NPI Number | 1720517444
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Entity Type | Individual
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Provider Name | ELIZABETH WILSON TINDAL MD MPH
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Gender | Female
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 26850 PROVIDENCE PKWY STE 460
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City | NOVI
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State | MI
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Zip | 48374-1265
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Country | US
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Telephone | 248-662-4272
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Fax | 248-662-3020
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Provider Business Mailing Address
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Address Line | 26850 PROVIDENCE PKWY STE 460
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City | NOVI
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State | MI
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Zip | 48374-1265
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Country | US
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Telephone | 248-662-4272
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Fax | 248-662-3020
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 60331227
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301514696
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License Number State | MI
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