MEDICARE: DR. WENDY I SADOFF 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
1	207N00000X	Dermatology Physician	4301054224	MI

General Provider Information

NPI Number	:	1952382079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDY I SADOFF MD

Provider Business Mailing Address
First Line	:	31360 NORTHWESTERN HWY
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-2523
Country	:	US
Telephone Number	:	248-855-3300
Fax Number	:

Provider Business Practice Location Address
First Line	:	31360 NORTHWESTERN HWY
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-2523
Country	:	US
Telephone Number	:	248-855-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	01/19/2016

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