Healthcare Provider Details

I. General information

NPI: 1548472079
Provider Name (Legal Business Name): AARON MICHAEL BOHRER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/07/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 DISCOVERY DR SUITE 200
LANSING MI
48910
US

IV. Provider business mailing address

3220 DISCOVERY DRIVE
LANSING MI
48910-4299
US

V. Phone/Fax

Practice location:
  • Phone: 517-975-8910
  • Fax:
Mailing address:
  • Phone: 517-975-8910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101016734
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: