Healthcare Provider Details

I. General information

NPI: 1053395889
Provider Name (Legal Business Name): JAMES BICOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24255 W 13 MILE RD SUITE 100
BINGHAM FARMS MI
48025-4320
US

IV. Provider business mailing address

24255 W 13 MILE RD SUITE 100
BINGHAM FARMS MI
48025-4320
US

V. Phone/Fax

Practice location:
  • Phone: 248-988-8085
  • Fax: 248-988-8565
Mailing address:
  • Phone: 248-988-8085
  • Fax: 248-988-8565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301101981
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number4301101981
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: