| Wayne Medical Center Pllc | |
|
1203 S Wayne Rd Westland MI 48186-4362 | |
| (734) 729-5780 | |
| Not Available |
| Full Name | Wayne Medical Center Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1203 S Wayne Rd, Westland, Michigan |
| Authorized Official Name and Position | Modini C Liyanage (OWNER) |
| Authorized Official Contact | 7347295780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne Medical Center Pllc 1203 S Wayne Rd Westland MI 48186-4362 Ph: () - | Wayne Medical Center Pllc 1203 S Wayne Rd Westland MI 48186-4362 Ph: (734) 729-5780 |
| NPI Number | 1134661143 |
|---|---|
| Provider Enumeration Date | 11/08/2016 |
| Last Update Date | 11/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134661143 | NPI | - | NPPES |
| DD1992 | Other | MI | RR MR |
| 4626563 | Medicaid | MI | |
| 1396960308 | Other | MI | NPI TYPE 2 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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