Provider Demographics
NPI:1275573461
Name:CORSI, PAUL J (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:CORSI
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 1:2525 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0286
Mailing Address - Country:US
Mailing Address - Phone:248-338-0100
Mailing Address - Fax:248-977-3014
Practice Address - Street 1:2525 S TELEGRAPH RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0286
Practice Address - Country:US
Practice Address - Phone:248-338-0100
Practice Address - Fax:248-977-3014
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301063928207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0005315725OtherAETNA
MI160F36364OtherBCBS OF MICHIGAN GROUP
MIG62917Medicare UPIN
MI0005315725OtherAETNA