MEDICARE: DR. ALEXIS B. MICHAELS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	4301056369	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336258979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXIS B. MICHAELS M.D.

Provider Business Mailing Address
First Line	:	4337 E GRAND RIVER AVE # 208
Second Line	:
City	:	HOWELL
State	:	MI
Zip	:	48843-6583
Country	:	US
Telephone Number	:	248-504-0588
Fax Number	:

Provider Business Practice Location Address
First Line	:	7575 GRAND RIVER RD
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48114-9309
Country	:	US
Telephone Number	:	248-504-0588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	12/21/2021

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