Healthcare Provider Details

I. General information

NPI: 1023360906
Provider Name (Legal Business Name): MICHAEL F PARSLOW JR. PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2012
Last Update Date: 10/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 STEPHENSON HWY BEAUMONT PAYOR CONTRACT SERVICES
TROY MI
48083-1103
US

IV. Provider business mailing address

3601 W 13 MILE RD
ROYAL OAK MI
48073-6712
US

V. Phone/Fax

Practice location:
  • Phone: 248-577-3519
  • Fax:
Mailing address:
  • Phone: 248-898-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601006418
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: