Melissa Wylie, DO | |
23050 West Rd, Suite 110, Brownstown Twp, MI 48183-1472 | |
(734) 671-9800 | |
(734) 671-7690 |
Full Name | Melissa Wylie |
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Gender | Female |
Speciality | Pediatrics |
Location | 23050 West Rd, Brownstown Twp, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043419674 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 5101017253 (Michigan) | Primary |
Entity Name | Edward W Sparrow Hospital Association |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831139088 PECOS PAC ID: 6709799166 Enrollment ID: O20040102000790 |
Mailing Address | Practice Location Address |
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Melissa Wylie, DO 23050 West Rd, Suite 110, Brownstown Twp, MI 48183-1472 Ph: (734) 671-9800 | Melissa Wylie, DO 23050 West Rd, Suite 110, Brownstown Twp, MI 48183-1472 Ph: (734) 671-9800 |
Andrew Joseph Dettore, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 23050 West Rd, Ste. 110, Brownstown Twp, MI 48183 Phone: 734-671-9800 Fax: 734-671-7690 | |
Susan Kay Kowalski, CPNP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 23050 West Rd Ste 110, Brownstown Twp, MI 48183 Phone: 734-671-9800 | |
Dionisia Atienza Sy, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 23050 West Rd, Suite 110, Brownstown Twp, MI 48183 Phone: 734-671-9800 Fax: 734-671-7690 |