Provider Demographics
NPI:1912958547
Name:WINFIELD, RAYMOND JOSEPH JR (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:JOSEPH
Last Name:WINFIELD
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:170 LOTHROP RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3528
Mailing Address - Country:US
Mailing Address - Phone:248-569-4897
Mailing Address - Fax:248-569-5226
Practice Address - Street 1:22250 PROVIDENCE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4825
Practice Address - Country:US
Practice Address - Phone:248-569-4897
Practice Address - Fax:248-569-5226
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-10-23
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Provider Licenses
StateLicense IDTaxonomies
MI4301045789208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1818415Medicaid
MI1818415Medicaid
MI0N91180003Medicare ID - Type Unspecified