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General NPI Number Information
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NPI Number | 1295722171
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Entity Type | Individual
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Provider Name | WILLIAM MICHELS III D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 02/22/2014
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Provider Practice Location Address
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Address Line | 4929 S TELEGRAPH RD
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-2027
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Country | US
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Telephone | 313-292-4820
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Fax | 313-292-4976
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Provider Business Mailing Address
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Address Line | 29600 S WIXOM RD
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City | WIXOM
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State | MI
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Zip | 48393-3430
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Country | US
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Telephone | 248-668-1900
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Fax | 248-668-1905
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101010990
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License Number State | MI
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