Provider Demographics
NPI:1740233634
Name:W.J.B., M.D., P.C.
Entity type:Organization
Organization Name:W.J.B., M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BINDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-484-5492
Mailing Address - Street 1:200 ARNET ST
Mailing Address - Street 2:SUITE 170
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5753
Mailing Address - Country:US
Mailing Address - Phone:734-484-5492
Mailing Address - Fax:734-484-5495
Practice Address - Street 1:200 ARNET ST
Practice Address - Street 2:SUITE 170
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5753
Practice Address - Country:US
Practice Address - Phone:734-484-5492
Practice Address - Fax:734-484-5495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077015207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty