Provider Demographics
NPI:1942395074
Name:WILLIAM G ANDERSON II DO PLLC
Entity Type:Organization
Organization Name:WILLIAM G ANDERSON II DO PLLC
Other - Org Name:WOMEN'S CARE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:248-477-0055
Mailing Address - Street 1:P O BOX 673333
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267
Mailing Address - Country:US
Mailing Address - Phone:248-477-0055
Mailing Address - Fax:248-477-0088
Practice Address - Street 1:20216 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1412
Practice Address - Country:US
Practice Address - Phone:248-477-0055
Practice Address - Fax:248-477-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007008207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P08910Medicare PIN
MIMI6652Medicare PIN
MIE37376Medicare UPIN
MI101051OtherGREAT LAKES HEALTH PLAN
MI015744OtherMIDWEST HEALTH PLAN HMO
MIE37376Medicare UPIN
0P08910Medicare PIN