← New Search
WAYLAND, MI 493489569
Organization
12TH STREET PLLC
NPI 1790470409
Active
Internal Medicine
Quick Facts
NPI Number
1790470409
Type
Organization (NPI-2)
Status
Active
Enumeration Date
2023-04-07
Last Updated (NPPES)
2023-08-15
Primary Specialty / Taxonomy
| Taxonomy | Internal Medicine |
| Taxonomy Code | 207R00000X |
Other Taxonomies
- Pediatrics
Mailing Address
3587 12TH STWAYLAND, MI 493489569
Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.