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General NPI Number Information
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NPI Number | 1962690941
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC INSTITUTE OF MICHIGAN PLLC
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 39000 7 MILE RD STE 2500
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City | LIVONIA
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State | MI
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Zip | 48152-1006
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Country | US
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Telephone | 734-464-0400
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Fax | 734-464-0404
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Provider Business Mailing Address
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Address Line | 37669 PEMBROKE AVE
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City | LIVONIA
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State | MI
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Zip | 48152-1050
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Country | US
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Telephone | 734-464-0400
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Fax | 734-464-0404
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL BRAGER
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Credential | MD
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Telephone | 734-464-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 54-0-H2-2486-0
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License Number State | MI
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