Fozo, Michael S
Fozo, Michael S is an individual health care provider with primary practice located at 21000 E 12 Mile Rd Suite 111, Saint Clair Shores MI 48081-1116. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck, which is considered as his primary health care specialty. Fozo, Michael S can be contacted via phone (586) 779-7610.Contact Information
Primary practice address
21000 E 12 Mile Rd Suite 111
Saint Clair Shores MI 48081-1116
Phone: (586) 779-7610
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck | 207YX0007X | MF075562 | Michigan |
Profile Details
| NPI number | 1114019627 |
|---|---|
| LBN Legal business name | Fozo, Michael S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2006 |
| Last updated | Oct 5th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114019627 | NPPES |
| Other | 4339229 | AETNA | |
| Other | H68407 | AETNA | |
| Other | 0501379 | AETNA | |
| MEDICAID | 4505853 | AETNA | |
| Other | 136815 | AETNA | |
| Other | P00014677 | AETNA | |
| Other | 141736 | AETNA | |
| Other | 16056 | AETNA | |
| Other | 6029816 | AETNA |
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