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WOODWARD BOULEVARD MEDICAL BUILDING
NPI 1689151946
Clinic/Center in Detroit, MI

Active since July 19, 2018
5830 CONNER ST, DETROIT, MI 48213(313) 924-1456(313) 636-2290 Get Directions Write a Review

NPPES record last updated: November 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 13, 2020, Jul 19, 2018 (2 updates tracked since 2018).

About Woodward Boulevard Medical Building NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WOODWARD BOULEVARD MEDICAL BUILDING (NPI 1689151946) is a healthcare organization registered as a clinic/center in Detroit, Michigan and active in the NPI registry since July 2018. The organization lists Latonya Wallace-hardiman, Owner, as its authorized official.

NPPES Registry Identity

NPI1689151946
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameWOODWARD BOULEVARD MEDICAL BUILDING
Location Address5830 CONNER STDetroit, MI 48213-3458
Mailing Address5830 Conner StDetroit, MI 48213-3458 · (313) 458-8804 · Fax (313) 636-2290
Phone(313) 924-1456
Fax(313) 636-2290
Organization SubpartNo
Authorized OfficialLatonya Wallace-hardimanOwner · (313) 715-7170
Enumeration DateJuly 19, 2018
Last NPPES UpdateNovember 13, 20202 updates tracked since enumeration
NPPES CertifiedNovember 13, 2020
✔ NPI 1689151946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
5830 CONNER ST, Detroit, MI 48213
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Other Identifiers 1

Other1053818039MI · N/a

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LATONYA WALLACE-HARDIMAN BA, MSA
Clinic/Center (Pain)
5830 CONNER ST
DETROIT, MI 48213
Wayne County (313) 924-1456
LIFE- ALYSIS KIDNEY CENTER, LLC
Health Maintenance Organization
5830 CONNER ST
DETROIT, MI 48213
Wayne County (313) 371-5433
ONE STEP AT A TIME PHYSICAL THERAPY, L.L.C.
Clinic/Center (Physical Therapy)
5830 CONNER ST
DETROIT, MI 48213
Wayne County (313) 499-8494
PRASHANTI BACHU FRANKLIN MD
Family Medicine
5830 CONNER ST
DETROIT, MI 48213
Wayne County (313) 458-8804

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Woodward Boulevard Medical Building's NPI number?

The NPI number for Woodward Boulevard Medical Building is 1689151946. It was assigned to this organization in the NPPES registry on July 19, 2018.

Where is Woodward Boulevard Medical Building located?

Woodward Boulevard Medical Building is located at 5830 Conner St, Detroit, MI 48213. The listed phone number is (313) 924-1456.

What is Woodward Boulevard Medical Building's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Woodward Boulevard Medical Building was last updated on November 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.