Healthcare Provider Details

I. General information

NPI: 1427031962
Provider Name (Legal Business Name): MICHAEL PATRICK DONAHUE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CROSS CREEK PKWY SUITE 200
AUBURN HILLS MI
48326-2774
US

IV. Provider business mailing address

3100 CROSS CREEK PKWY SUITE 200
AUBURN HILLS MI
48326-2774
US

V. Phone/Fax

Practice location:
  • Phone: 248-377-8000
  • Fax: 248-377-2929
Mailing address:
  • Phone: 248-377-8000
  • Fax: 248-377-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5101014239
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number5101014239
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number5101014239
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: