MEDICARE: WL PHYSICIANS P.C.

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
1	208600000X	Surgery Physician	4301033364	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020E018760	OTHER	MI	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659416253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WL PHYSICIANS P.C.

Provider Business Mailing Address
First Line	:	1385 E. 12 MILE RD. SUITE 200
Second Line	:
City	:	MADISON HIEGHTS
State	:	MI
Zip	:	48071
Country	:	US
Telephone Number	:	248-284-1760
Fax Number	:	248-284-1780

Provider Business Practice Location Address
First Line	:	1385 E 12 MILE RD STE 200
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-2649
Country	:	US
Telephone Number	:	248-284-1760
Fax Number	:	248-284-1780

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL H WOOD
Credential	:	M.D, F.A.C.S.
Telephone Number	:	248-284-1760

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	10/17/2008

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Directions to “WL PHYSICIANS P.C. ” Practice Location

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