Individual provider · Type 1 NPI

Tyson Don Waliezer, MD

Student in an Organized Health Care Education/Training Program · Detroit, MI

NPI number 1790348076 Active

Practice location

4160 John R Street, Harper Professional Building, Suite 615
Detroit, MI 48201

Call (313) 745-4195 Map

Mailing address

25909 Clark St
Novi, MI 48375-1622

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2 other providers at this address

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About NPI 1790348076

Tyson Don Waliezer, MD's National Provider Identifier is 1790348076, issued on Apr 22, 2019. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Detroit, MI. The record was last updated on Apr 2, 2020.