Provider Demographics
NPI:1891737847
Name:FRENCH, WENDY LYNNE (DO)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNNE
Last Name:FRENCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 BYRON CENTER AVE SW
Mailing Address - Street 2:MEDICAL ADMINISTRATION
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-9606
Mailing Address - Country:US
Mailing Address - Phone:616-252-3243
Mailing Address - Fax:616-252-0260
Practice Address - Street 1:5950 METRO WAY SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519
Practice Address - Country:US
Practice Address - Phone:616-252-8100
Practice Address - Fax:616-252-8181
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016484207R00000X, 207RH0003X
MI016484207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1891737847Medicaid
MI110F163940OtherBCBS
MI1447261730OtherBCBSM - WMCC
MIP00423776OtherMEDICARE RAILROAD
MI4782460Medicaid
MI1447261730OtherBCBSM - WMCC
MII41086Medicare UPIN
MI0F16394036Medicare ID - Type Unspecified