Healthcare Provider Details

I. General information

NPI: 1508032541
Provider Name (Legal Business Name): MICHAEL J. SORSCHER M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4442 GENESYS PKWY
GRAND BLANC MI
48439-8072
US

IV. Provider business mailing address

4442 GENESYS PKWY
GRAND BLANC MI
48439-8072
US

V. Phone/Fax

Practice location:
  • Phone: 810-606-6990
  • Fax: 810-606-6967
Mailing address:
  • Phone: 810-606-6990
  • Fax: 810-606-6967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number4301051814
License Number StateMI

VIII. Authorized Official

Name: DR. MICHAEL J SORSCHER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 810-606-6990