Back, William R
Back, William R is an individual health care provider with primary practice located at 30626 Ford Rd , Garden City MI 48135-1870. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Back, William R can be contacted via phone (734) 261-9211.Contact Information
Primary practice address
30626 Ford Rd
Garden City MI 48135-1870
Phone: (734) 261-9211
Fax: (734) 261-8537
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | WB006125 | Michigan |
Profile Details
| NPI number | 1720019383 |
|---|---|
| LBN Legal business name | Back, William R |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Apr 7th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720019383 | NPPES |
| Michigan | MEDICAID | 4591495 |
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