MEDICARE: MICHAEL BISCHOFF

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	2085R0202X	Diagnostic Radiology Physician	4301057624	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9519530	OTHER	MI	MULTIPLAN
2	636844	OTHER	MI	BCBS

General Provider Information

NPI Number	:	1376502542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BISCHOFF

Provider Business Mailing Address
First Line	:	32000 NORTHWESTERN HWY STE 215
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-1570
Country	:	US
Telephone Number	:	248-344-9110
Fax Number	:	248-344-9111

Provider Business Practice Location Address
First Line	:	2251 N SQUIRREL RD STE 301
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-4608
Country	:	US
Telephone Number	:	248-344-9110
Fax Number	:	248-344-9111

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	11/05/2019

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Directions to “ MICHAEL BISCHOFF ” Practice Location

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