Provider Demographics
NPI:1245218734
Name:DARGAY, MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DARGAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38935 ANN ARBOR RD
Mailing Address - Street 2:CREDENTIALING/PAYER CONTRACTING
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3397
Mailing Address - Country:US
Mailing Address - Phone:734-632-0175
Mailing Address - Fax:734-632-0182
Practice Address - Street 1:5450 FORT ST
Practice Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-4601
Practice Address - Country:US
Practice Address - Phone:734-671-3883
Practice Address - Fax:734-671-3546
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009951207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11274482OtherCAQH
MI1245218734Medicaid
MI0158208345OtherBCBS
MD009951OtherBCBS
MD009951OtherBCBS
MI0158208345OtherBCBS
Q26294327Medicare PIN
MIN87430010Medicare ID - Type UnspecifiedPEC SJMM (PHYSICIANS)
MI1245218734Medicaid
MIQ26294327Medicare PIN