Doctor Name: | DR. ARIEL ANDRE WAITZMAN |
NPI Number: | 1639149677 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 4301071017 |
Business Practice Address: | 15212 Michigan Ave Dearborn, MI - 481263497 |
Business Phone Number: | 3135828853 |
Business Fax Number: | 3135826417 |
Mailing Address: | 4881 Kensington Rd, BLOOMFIELD HILLS |
State: | MI |
Postal Code: | 483043653 |
Phone Number: | 2485946734 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 4301071017 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |