Healthcare Provider Details

I. General information

NPI: 1861839912
Provider Name (Legal Business Name): MAX FEINSTEIN D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 10/26/2024
Certification Date: 10/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 TELEGRAPH RD STE G1
BLOOMFIELD HILLS MI
48301-1775
US

IV. Provider business mailing address

3871 GLEN FALLS DR
BLOOMFIELD HILLS MI
48302-1226
US

V. Phone/Fax

Practice location:
  • Phone: 248-270-2204
  • Fax:
Mailing address:
  • Phone: 248-212-5939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101020573
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number5101020573
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: