Provider Demographics
NPI:1174514418
Name:MICHELS, ELIZABETH H (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:H
Last Name:MICHELS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:32905 W 12 MILE RD
Mailing Address - Street 2:STE 330
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3342
Mailing Address - Country:US
Mailing Address - Phone:248-553-2900
Mailing Address - Fax:248-553-7546
Practice Address - Street 1:32905 W 12 MILE RD
Practice Address - Street 2:STE 330
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3342
Practice Address - Country:US
Practice Address - Phone:248-553-2900
Practice Address - Fax:248-553-7546
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301047633207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1802792Medicaid
OF371421071Medicare ID - Type Unspecified
MI1802792Medicaid