Provider Demographics
NPI:1487717807
Name:NORTHWOOD PHYSICIANS, P.C.
Entity type:Organization
Organization Name:NORTHWOOD PHYSICIANS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAWLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-544-2293
Mailing Address - Street 1:28905 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-0923
Mailing Address - Country:US
Mailing Address - Phone:248-544-2293
Mailing Address - Fax:248-544-1624
Practice Address - Street 1:28905 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-0923
Practice Address - Country:US
Practice Address - Phone:248-544-2293
Practice Address - Fax:248-544-1624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010038207Q00000X
MI4301033906207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB47313Medicare UPIN
MIE85740Medicare UPIN
MI0F370266011Medicare ID - Type Unspecified