Provider Demographics
NPI:1417952839
Name:SENSOLI, ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:SENSOLI
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 1:850 W NORTH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3196
Mailing Address - Country:US
Mailing Address - Phone:877-852-8463
Mailing Address - Fax:517-817-0144
Practice Address - Street 1:1600 COMMERCE PARK DR
Practice Address - Street 2:STE 100
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1452
Practice Address - Country:US
Practice Address - Phone:734-475-5970
Practice Address - Fax:734-475-3277
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301052452207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
180009240OtherRAILROAD MEDICARE
MI3041698Medicaid
MI180F373640OtherBCBSM
MI180H149970OtherBCBSM
MI3104303Medicaid
MI3041698Medicaid
MI180F373640OtherBCBSM
MI3104303Medicaid