| Doctor Name: | ROBIN WAWERSIK |
| NPI Number: | 1003184268 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 4704231812 |
| Business Practice Address: | 18181 Oakwood Blvd Ste 207 Dearborn, MI - 481245031 |
| Business Phone Number: | 3132715565 |
| Business Fax Number: | 3132711053 |
| Mailing Address: | 22939 Nowlin St, DEARBORN |
| State: | MI |
| Postal Code: | 48124 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/02/2011 |
| NPI Last Update Date: | 12/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 4704231812 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |