MEDICARE: DR. NORMA INOCENCIO MD

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	208000000X	Pediatrics Physician	NI040049	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	114133	OTHER	MI	CARE CHOICES
2	148135	OTHER	MI	GLHP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	350F314450	OTHER	MI	BCBS OF MICHIGAN

General Provider Information

NPI Number	:	1851386254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORMA INOCENCIO MD

Provider Business Mailing Address
First Line	:	2055 E 14 MILE RD
Second Line	:	SUITE 120
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7256
Country	:	US
Telephone Number	:	248-645-1740
Fax Number	:	248-645-5304

Provider Business Practice Location Address
First Line	:	2055 E 14 MILE RD
Second Line	:	SUITE 120
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7256
Country	:	US
Telephone Number	:	248-645-1740
Fax Number	:	248-645-5304

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	03/22/2026

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Directions to “ DR. NORMA INOCENCIO MD” Practice Location

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