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NPI Code Detail

MEDICARE: MICHAEL C TILLER D.O.

MEDICARE: MICHAEL C TILLER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician04886KY
2207P00000XEmergency Medicine Physician5101021413MI
3207P00000XEmergency Medicine Physician34.014007OH

General Provider Information

NPI Number : 1114345378
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL C TILLER D.O.
Provider Business Mailing Address
First Line : 650 STEWART RD
Second Line :
City : MONROE
State : MI
Zip : 48162-4222
Country : US
Telephone Number : 734-240-8430
Fax Number : 734-240-8495
Provider Business Practice Location Address
First Line : 650 STEWART RD
Second Line :
City : MONROE
State : MI
Zip : 48162-4222
Country : US
Telephone Number : 734-240-8430
Fax Number : 734-240-8495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2014
Last Update Date : 08/20/2025

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Directions to “ MICHAEL C TILLER D.O.” Practice Location

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