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General NPI Number Information
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NPI Number | 1912958547
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Entity Type | Individual
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Provider Name | RAYMOND JOSEPH WINFIELD JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 10/23/2008
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Provider Practice Location Address
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Address Line | 22250 PROVIDENCE DR SUITE 203
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4825
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Country | US
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Telephone | 248-569-4897
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Fax | 248-569-5226
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Provider Business Mailing Address
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Address Line | 170 LOTHROP RD
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-3528
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Country | US
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Telephone | 248-569-4897
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Fax | 248-569-5226
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4301045789
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License Number State | MI
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