Healthcare Provider Details

I. General information

NPI: 1932100369
Provider Name (Legal Business Name): MICHAEL D. COLMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 02/18/2023
Certification Date: 02/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 QUARTON RD
BLOOMFIELD HILLS MI
48302-2651
US

IV. Provider business mailing address

4550 QUARTON RD
BLOOMFIELD HILLS MI
48302-2651
US

V. Phone/Fax

Practice location:
  • Phone: 248-862-2273
  • Fax: 248-862-2724
Mailing address:
  • Phone: 248-862-2273
  • Fax: 248-862-2724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number43010-28241
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number43010-28241
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number43010-28241
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number43010-28241
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number43010-28241
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number4301028241
License Number StateMI
# 7
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number43010-28242
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: