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WOODWARD GASTROENTEROLOGY PC NPI 1104247899


NPI Information

NPI: 1104247899
Provider Name: WOODWARD GASTROENTEROLOGY PC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 23D2224404

Address:
1695 12 MILE RD
SUITE 220
BERKLEY, MI
ZIP 48072
Phone: (248) 229-8354
Get Directions

WOODWARD GASTROENTEROLOGY PC is a gastroenterology internal medicine in Berkley, MI. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. WOODWARD GASTROENTEROLOGY PC NPI is 1104247899. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1695 12 MILE RD
SUITE 220
BERKLEY, MI
ZIP 48072-182
Phone: (248) 229-8354

The provider's authorized official is Tusar Kishore Desai .
The authorized official title is Owner and has the following contact phone number (248) 229-8354.

The CLIA number assigned to this NPI record is 23D2224404 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/23/2013 and was last updated on 3/7/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterology4301044285MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E76131MEDICARE UPINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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