Provider Demographics
NPI:1235120551
Name:MARGOLIS, MICHAEL K (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:K
Last Name:MARGOLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3950 S ROCHESTER RD
Mailing Address - Street 2:STE 1200
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5160
Mailing Address - Country:US
Mailing Address - Phone:248-844-6000
Mailing Address - Fax:248-844-6159
Practice Address - Street 1:3950 S ROCHESTER RD
Practice Address - Street 2:STE 1200
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5160
Practice Address - Country:US
Practice Address - Phone:248-844-6000
Practice Address - Fax:248-844-6159
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074147207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1235120551Medicaid
MI700H217350OtherGROUP BCN, BLUE SHIELD
MI1106345511OtherINDIVIDUAL BLUE SHIELD
H68852OtherHAP
MIM92440036Medicare PIN
H68852OtherHAP