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NPI Code Detail

MEDICARE: DR. WENDY FRAUCHIGER MD

MEDICARE:  DR. WENDY  FRAUCHIGER  MD
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
1207ZP0105XClinical Pathology/Laboratory Medicine Physician4301071147MI

General Provider Information

NPI Number : 1720062201
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WENDY FRAUCHIGER MD
Provider Business Mailing Address
First Line : 15855 19 MILE RD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-3504
Country : US
Telephone Number : 586-872-8121
Fax Number :
Provider Business Practice Location Address
First Line : 15855 19 MILE RD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-3504
Country : US
Telephone Number : 586-872-8121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 01/18/2019

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