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NPI Code Detail

MEDICARE: DR. DAVID P MICHELIN MD

MEDICARE: DR. DAVID P MICHELIN MD
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
1207VX0201XGynecologic Oncology Physician4301056115MI

Other Identifiers

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

General Provider Information

NPI Number : 1831180140
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID P MICHELIN MD
Provider Business Mailing Address
First Line : 2513 MOMENTUM PL
Second Line :
City : CHICAGO
State : IL
Zip : 60689-5325
Country : US
Telephone Number : 231-935-6080
Fax Number : 231-935-6081
Provider Business Practice Location Address
First Line : 217 S MADISON STREET
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2320
Country : US
Telephone Number : 231-392-8400
Fax Number : 231-935-7888
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2005
Last Update Date : 03/15/2021

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Directions to “ DR. DAVID P MICHELIN MD” Practice Location

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