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NPI Code Detail

MEDICARE: DR. MICHAEL D COLBURN

MEDICARE: DR. MICHAEL D COLBURN
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
12086S0129XVascular Surgery Physician4301079215MI

General Provider Information

NPI Number : 1760486260
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL D COLBURN
Provider Business Mailing Address
First Line : 3930 CEDAR RUN RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-9687
Country : US
Telephone Number : 231-935-0390
Fax Number :
Provider Business Practice Location Address
First Line : 3930 CEDAR RUN RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-9687
Country : US
Telephone Number : 231-935-0390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 03/18/2021

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Directions to “ DR. MICHAEL D COLBURN ” Practice Location

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