MEDICARE: DR. WILLIAM MICHELS III 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	207R00000X	Internal Medicine Physician	5101010990	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295722171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM MICHELS III D.O.

Provider Business Mailing Address
First Line	:	29600 S WIXOM RD
Second Line	:
City	:	WIXOM
State	:	MI
Zip	:	48393-3430
Country	:	US
Telephone Number	:	248-668-1900
Fax Number	:	248-668-1905

Provider Business Practice Location Address
First Line	:	4929 S TELEGRAPH RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48125-2027
Country	:	US
Telephone Number	:	313-292-4820
Fax Number	:	313-292-4976

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	02/22/2014

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