Provider Demographics
NPI:1245233683
Name:HEALY, MICHAEL A (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:HEALY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:702 COMMERCE DR
Mailing Address - Street 2:STE100
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5239
Mailing Address - Country:US
Mailing Address - Phone:419-794-3475
Mailing Address - Fax:419-873-6418
Practice Address - Street 1:702 COMMERCE DR
Practice Address - Street 2:STE100
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5239
Practice Address - Country:US
Practice Address - Phone:419-794-3475
Practice Address - Fax:419-873-6418
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2023-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35060880H207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH807578Medicaid
OH807578Medicaid
OHC33021Medicare UPIN