| Peter L Wickens D.o.,p.c. | |
|
14050 E 14 Mile Rd Warren MI 48088-5765 | |
| (586) 293-2088 | |
| (586) 293-5502 |
| Full Name | Peter L Wickens D.o.,p.c. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 14050 E 14 Mile Rd, Warren, Michigan |
| Authorized Official Name and Position | Peter L Wickens (PRESIDENT) |
| Authorized Official Contact | 5862932088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter L Wickens D.o.,p.c. 14050 E 14 Mile Rd Warren Warren MI 48088-5765 Ph: (586) 293-2088 | Peter L Wickens D.o.,p.c. 14050 E 14 Mile Rd Warren MI 48088-5765 Ph: (586) 293-2088 |
| NPI Number | 1003083957 |
|---|---|
| Provider Enumeration Date | 05/09/2008 |
| Last Update Date | 05/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003083957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 5101006061 (Michigan) | Primary |
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