Dr. Michael S Fozo
Plastic Surgeon (Head & Neck)
21000 E 12 Mile Rd Suite 111
Saint Clair Shores
, Michigan 48081-1116
Dr. Michael S Fozo
Plastic Surgeon (Head & Neck)
21000 E 12 Mile Rd Suite 111
Saint Clair Shores
, Michigan 48081-1116
(586) 445-2523
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About
Features
Specialties
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Dr. Michael S Fozo
- 21000 E 12 Mile Rd Ste 111
- St Clair Shores, MI
- Zip : 48081
- Fax : (586) 445-2523
- Phone : (586) 779-7610
Second Address
- Dr. Michael S Fozo
- 21000 E 12 Mile Rd Suite 111
- Saint Clair Shores, MI
- Zip : 48081-1116
- Phone : (586) 779-7610
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YX0007X | Plastic Surgeon (Head & Neck) | MF075562 | MI |
National Provider Identifier
| NPI | 1114019627 |
|---|---|
| Provider Name | Dr. Michael S Fozo |
| First Address | St Clair Shores, MI 48081 |
| Second Address | Saint Clair Shores, MI 48081-1116 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/09/2006 |
| Last Update Date | 05/10/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0501379 | BLUE CARE NETWORK (01) | |
| 136815 | CARE CHOICES (01) | |
| 141736 | GREAT LAKES HEALTH PLAN (01) | |
| 16056 | MCAR (01) | |
| 4339229 | AETNA (01) | |
| 4505853 | (05) | MI |
| 6029816 | CIGNA (01) | |
| H68407 | (02) | MI |
| H68407 | HEALTH ALLIANCE PLAN (01) | |
| P00014677 | RAILROAD MEDICARE (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.