Provider Demographics
NPI:1437134533
Name:SILLS, MICHAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:SILLS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:29992 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3292
Mailing Address - Country:US
Mailing Address - Phone:248-851-1430
Mailing Address - Fax:248-851-5182
Practice Address - Street 1:32255 NORTHWESTERNHWY
Practice Address - Street 2:SUITE C
Practice Address - City:FARMINGTIN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-723-5880
Practice Address - Fax:248-723-5889
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2015-03-02
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Provider Licenses
StateLicense IDTaxonomies
MI4301048897207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI06317711OtherBCBS INDIVIDUAL
MI1437134533Medicaid
MIB44648OtherHAP
MI110246812OtherRR MEDICARE
MI700H273300OtherBLUE SHIELD
MI06317711OtherBCBS INDIVIDUAL
MIB44648OtherHAP
MI0N65510-001Medicare ID - Type Unspecified