MEDICARE: HALEY MAE JOHNSON PA

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	363A00000X	Physician Assistant	5601007944	MI
2	363A00000X	Physician Assistant	0010-14027	NC

General Provider Information

NPI Number	:	1386195295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY MAE JOHNSON PA

Provider Business Mailing Address
First Line	:	1 FORD PL STE 3A
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-3450
Country	:	US
Telephone Number	:	800-999-5829
Fax Number	:	313-874-4806

Provider Business Practice Location Address
First Line	:	6777 W MAPLE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3013
Country	:	US
Telephone Number	:	248-661-6591
Fax Number	:

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

Provider Enumeration Date	:	10/17/2016
Last Update Date	:	01/08/2026

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1992662290 — TANISHA GISELE JARRETT
Practice Location Address:

6773 W MAPLE RD
WEST BLOOMFIELD, MI
48322-3013

Practice Phone: 313-588-9322
Practice Fax:

1497754816 — MS. LYNNE CAMILLE GAFFORD CNP
Practice Location Address:

6777 W MAPLE RD
WEST BLOOMFIELD, MI
48322-3013

Practice Phone: 248-325-1099
Practice Fax: 248-325-1610

1437158862 — DR. STEPHEN A LIROFF M.D.
Practice Location Address:

6777 W MAPLE RD
WEST BLOOMFIELD, MI
48322-3013

Practice Phone: 248-661-7080
Practice Fax: 248-661-7543

1326040262 — BLAKE ANGOVE CSW
Practice Location Address:

6773 W MAPLE RD , MAPLEGROVE CENTER
WEST BLOOMFIELD, MI
48322-3013

Practice Phone: 248-661-6535
Practice Fax: 248-661-6165

1780669028 — DR. JAMES BOMBARD
Practice Location Address:

6777 W MAPLE RD
WEST BLOOMFIELD, MI
48322-3013

Practice Phone: 248-661-7917
Practice Fax:

Directions to “ HALEY MAE JOHNSON PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.