Provider Demographics
NPI:1073595039
Name:QUINN, MICHAEL I (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:I
Last Name:QUINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 S ROCHESTER RD
Mailing Address - Street 2:STE 225
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3183
Mailing Address - Country:US
Mailing Address - Phone:248-650-5300
Mailing Address - Fax:248-650-5302
Practice Address - Street 1:1349 S ROCHESTER RD
Practice Address - Street 2:STE 225
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3183
Practice Address - Country:US
Practice Address - Phone:248-650-5300
Practice Address - Fax:248-650-5302
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071988207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
7277555OtherAETNA
N9859003Medicare ID - Type Unspecified
MI0266060002Medicare NSC
MIN9859003Medicare PIN
I17007Medicare UPIN