Provider Demographics
NPI:1336507466
Name:DOUTSAS, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DOUTSAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30900 FORD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1892
Mailing Address - Country:US
Mailing Address - Phone:734-838-0353
Mailing Address - Fax:734-838-0959
Practice Address - Street 1:30900 FORD RD
Practice Address - Street 2:SUITE C
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1892
Practice Address - Country:US
Practice Address - Phone:734-838-0353
Practice Address - Fax:734-838-0959
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor