Wizenberg, Theodore A
Wizenberg, Theodore A is an sole proprietor health care provider with primary practice located at 23901 Lahser Rd , Southfield MI 48034-6035. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wizenberg, Theodore A can be contacted via phone (248) 357-3360.Contact Information
Primary practice address
23901 Lahser Rd
Southfield MI 48034-6035
Phone: (248) 357-3360
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301038081 | Michigan |
Profile Details
| NPI number | 1932102423 |
|---|---|
| LBN Legal business name | Wizenberg, Theodore A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 27th, 2005 |
| Last updated | Oct 23rd, 2007 - about 18 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 | 1932102423 | NPPES |
| Michigan | Other | 1106338231 | BCBS |
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