Healthcare Provider Details

I. General information

NPI: 1487275509
Provider Name (Legal Business Name): ERIKA MICHELIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

577 MICHIGAN AVE STE 202
HOLLAND MI
49423-4911
US

IV. Provider business mailing address

577 MICHIGAN AVE STE 202
HOLLAND MI
49423-4911
US

V. Phone/Fax

Practice location:
  • Phone: 616-394-0673
  • Fax:
Mailing address:
  • Phone: 616-394-0673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5101028664
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: