Healthcare Provider Details

I. General information

NPI: 1487947362
Provider Name (Legal Business Name): WILLIAM BRIAN ACKER II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2011
Last Update Date: 10/22/2020
Certification Date: 10/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 TELEGRAPH RD STE 100
TAYLOR MI
48180-3330
US

IV. Provider business mailing address

26901 BEAUMONT BLVD STE 3D
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 313-887-6000
  • Fax: 313-887-6005
Mailing address:
  • Phone: 947-522-1863
  • Fax: 947-522-0307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301098266
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: