Provider Demographics
NPI:1376500090
Name:BROOKS, MICHAEL FULTON (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FULTON
Last Name:BROOKS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:12851 EAST GRAND RIVER
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116
Mailing Address - Country:US
Mailing Address - Phone:810-227-1211
Mailing Address - Fax:810-220-5509
Practice Address - Street 1:12851 EAST GRAND RIVER
Practice Address - Street 2:BRIGHTON HOSPITAL
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116
Practice Address - Country:US
Practice Address - Phone:810-227-1211
Practice Address - Fax:810-220-5509
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine