MEDICARE: DR. MICHAEL DARGAY 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
1	207P00000X	Emergency Medicine Physician	5101009951	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11274482	OTHER		CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0158208345	OTHER	MI	BCBS
4	MD009951	OTHER		BCBS

General Provider Information

NPI Number	:	1245218734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DARGAY D.O.

Provider Business Mailing Address
First Line	:	38935 ANN ARBOR RD
Second Line	:	CREDENTIALING/PAYER CONTRACTING
City	:	LIVONIA
State	:	MI
Zip	:	48150-3397
Country	:	US
Telephone Number	:	734-632-0175
Fax Number	:	734-632-0182

Provider Business Practice Location Address
First Line	:	5450 FORT ST
Second Line	:	EMERGENCY MEDICINE DEPARTMENT
City	:	TRENTON
State	:	MI
Zip	:	48183-4601
Country	:	US
Telephone Number	:	734-671-3883
Fax Number	:	734-671-3546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	07/19/2010

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Directions to “ DR. MICHAEL DARGAY D.O.” Practice Location

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