Ira Mickelson is a Addiction Medicine in Troy, Michigan. Ira Mickelson practices all healthcare services and medical treatments related to Addiction Medicine. The NPI Number for Ira Mickelson is 1760576516. The last update date is 2018-11-13.
Ira Mickelson's current location address is 1777 Axtell, Troy, Michigan. You can contact this provider via phone number 2488226200. The mailing address for Ira Mickelson is 1777 Axtell, Troy, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ira Mickelson |
|---|---|
| Address | 1777 Axtell, Troy, Michigan |
| Phone Number | 2488226200 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1760576516 |
|---|---|
| Provider Enumeration Date | 2006-10-03 |
| Last Updated Date | 2018-11-13 |
Provider Mailing Address Detail
| Address | 1777 Axtell |
|---|---|
| City | Troy |
| State | Michigan (MI) |
| Post Code | 48084 |
| Phone Number | 2488226200 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction Medicine |
|---|---|
| Taxonomy | 207Qa0401X |
| Licence No | 5304001863 |
|
Definition: A family medicine physician who specializes in the diagnosis and treatment of addictions. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 160F318220 | MI | BCBS OF MICHIGAN |
Post Comment/ Review Below
What is the unique provider identifier assigned to Ira Mickelson?
The Ira Mickelson has been issued the NPI (National Provider Identifier) 1760576516 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Ira Mickelson is physically located?
The Ira Mickelson is situated at the following address: 1777 Axtell, Troy, MI 48084.
What is Ira Mickelson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Ira Mickelson's area of specialization is Addiction Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Qa0401X.
When did Ira Mickelson receive its 1760576516 assignment?
The Ira Mickelson was assigned its 1760576516 on 2006-10-03, which is the date when this unique identifier was issued to the organization.
As of what date were the details related to Ira Mickelson most recently updated or revised?
The information pertaining to Ira Mickelson, including its address, specialty, and other relevant details, was last updated or revised on 2018-11-13.