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NPI Code Detail

MEDICARE: MICHAEL WEI WANG PT

MEDICARE: MICHAEL WEI WANG PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501011238MI

General Provider Information

NPI Number : 1285807826
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL WEI WANG PT
Provider Business Mailing Address
First Line : 34612 DEQUINDRE RD.
Second Line : SUITE C
City : STERLING HEIGHTS
State : MI
Zip : 48310-5233
Country : US
Telephone Number : 586-983-4101
Fax Number :
Provider Business Practice Location Address
First Line : 34612 DEQUINDRE RD
Second Line : SUITE C
City : STERLING HEIGHTS
State : MI
Zip : 48310-5233
Country : US
Telephone Number : 586-983-4101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2008
Last Update Date : 04/17/2009

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