NPI 1003125774
Envision Medical Group PLLC
Practice location
- Address
- 12660 Ten Mile Rd, South Lyon, MI 48178-9141
- Phone
- (248) 348-1131
- Mailing address
- 27275 Haggerty Rd STE 500, Novi, MI 48377-3635
Authorised official
- Name
- Michael Wayne
- Title
- Managing Member
- Phone
- (248) 348-8700
Registered specialties (5)
Family Medicine Physician
Primary
Cardiovascular Disease Physician
Diagnostic Radiology Physician
Primary Podiatric Medicine Podiatrist
Physician Assistant
Registry record
- NPI
- 1003125774
- Entity type
- Organization
- NPI issued
- 29 Sep 2010
- Record last updated
- 23 Feb 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.