Provider Demographics
NPI:1952382079
Name:SADOFF, WENDY I (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:I
Last Name:SADOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31360 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2523
Mailing Address - Country:US
Mailing Address - Phone:248-855-3300
Mailing Address - Fax:
Practice Address - Street 1:31360 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2523
Practice Address - Country:US
Practice Address - Phone:248-855-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301054224207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F25578Medicare UPIN
ON21240Medicare ID - Type Unspecified
MIMI4547001Medicare PIN