Healthcare Provider Details

I. General information

NPI: 1073773156
Provider Name (Legal Business Name): MICHELLE AUBIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E MICHIGAN AVE STE 300
JACKSON MI
49201-1853
US

IV. Provider business mailing address

1201 E MICHIGAN AVE STE 300
JACKSON MI
49201-1853
US

V. Phone/Fax

Practice location:
  • Phone: 517-205-1431
  • Fax: 517-205-1432
Mailing address:
  • Phone: 517-205-1431
  • Fax: 517-205-1432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number236805
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: