Healthcare Provider Details

I. General information

NPI: 1437145901
Provider Name (Legal Business Name): STEVEN A MIGDAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 ORCHARD LAKE RD SUITE 306
WEST BLOOMFIELD MI
48322-3405
US

IV. Provider business mailing address

6900 ORCHARD LAKE RD SUITE 306
WEST BLOOMFIELD MI
48322-3405
US

V. Phone/Fax

Practice location:
  • Phone: 248-855-6663
  • Fax: 248-855-7546
Mailing address:
  • Phone: 248-855-6663
  • Fax: 248-855-7546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number4301036408
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: