Provider Demographics
NPI:1558480913
Name:ARMSTRONG, WARWICK DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:WARWICK
Middle Name:DAVID
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10856 M 52
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48158-9412
Mailing Address - Country:US
Mailing Address - Phone:734-709-1931
Mailing Address - Fax:734-428-0960
Practice Address - Street 1:31584 SCHOOLCRAFT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1843
Practice Address - Country:US
Practice Address - Phone:734-522-5188
Practice Address - Fax:734-428-0960
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002961103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D71247OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI0H24637Medicare ID - Type Unspecified