| Wellington Provider Group, PC | |
|
400 Renaissance Ctr Ste 2200 Detroit MI 48243-1502 | |
| (859) 439-0400 | |
| Not Available |
| Full Name | Wellington Provider Group, PC |
|---|---|
| Speciality | General Practice |
| Location | 400 Renaissance Ctr Ste 2200, Detroit, Michigan |
| Authorized Official Name and Position | Brittany Dennis (CREDENTIALING MANAGER) |
| Authorized Official Contact | 8595188817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellington Provider Group, PC 535 Wellington Way Ste 330 Lexington KY 40503-1331 | Wellington Provider Group, PC 400 Renaissance Ctr Ste 2200 Detroit MI 48243-1502 Ph: (859) 439-0400 |
| NPI Number | 1437869922 |
|---|---|
| Provider Enumeration Date | 11/25/2022 |
| Last Update Date | 11/25/2022 |
| Certification Date | 11/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437869922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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