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General NPI Number Information
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NPI Number | 1447068051
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Entity Type | Organization
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Legal Business Name | SKYE MICHIGAN PLLC
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Dates
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Enumeration Date | 12/28/2024
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Last Update Date | 12/28/2024
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Provider Practice Location Address
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Address Line | 31700 TELEGRAPH RD STE 230
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City | BINGHAM FARMS
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State | MI
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Zip | 48025-3466
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Country | US
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Telephone | 248-587-8267
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Fax | 248-973-1345
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Provider Business Mailing Address
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Address Line | 31700 TELEGRAPH RD STE 230
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City | BINGHAM FARMS
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State | MI
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Zip | 48025-3466
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Country | US
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Telephone | 248-587-8267
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Fax | 248-973-1345
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ROBERT GLENN
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Credential | MD
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Telephone | 248-587-8267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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