Doctor, Michael R

Doctor, Michael R is an individual health care provider with primary practice located at 2115 M 119 , Petoskey MI 49770-8914. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Doctor, Michael R can be contacted via phone (231) 347-2518.

Contact Information

Primary practice address
2115 M 119 Petoskey MI 49770-8914
Phone: (231) 347-2518
Fax: (231) 347-8530
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 2901014067 Michigan

Profile Details

NPI number 1255443321
LBN Legal business name Doctor, Michael R
Credentials D.D.S., M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255443321 NPPES
Michigan Other 5166284 BCBS OF MICHIGAN-MEDICAL
Michigan Other D140670 BCBS OF MICHIGAN-MEDICAL
Michigan MEDICAID 288090 BCBS OF MICHIGAN-MEDICAL

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