Healthcare Provider Details

I. General information

NPI: 1730377292
Provider Name (Legal Business Name): ANTHONY B. MICHAELS, D.O., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2007
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 TOWNSEND ST SUITE 302
BIRMINGHAM MI
48009-6008
US

IV. Provider business mailing address

189 TOWNSEND ST SUITE 302
BIRMINGHAM MI
48009-6008
US

V. Phone/Fax

Practice location:
  • Phone: 248-540-0555
  • Fax: 248-540-2180
Mailing address:
  • Phone: 248-540-0555
  • Fax: 248-540-2180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number5101806943
License Number StateMI

VIII. Authorized Official

Name: DR. ANTHONY B MICHAELS
Title or Position: OWNER
Credential: D.O.
Phone: 248-540-0555