Provider Demographics
NPI:1508032541
Name:MICHAEL J. SORSCHER M.D., P.C.
Entity Type:Organization
Organization Name:MICHAEL J. SORSCHER M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SORSCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-606-6990
Mailing Address - Street 1:4442 GENESYS PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8072
Mailing Address - Country:US
Mailing Address - Phone:810-606-6990
Mailing Address - Fax:810-606-6967
Practice Address - Street 1:4442 GENESYS PKWY
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8072
Practice Address - Country:US
Practice Address - Phone:810-606-6990
Practice Address - Fax:810-606-6967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301051814261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4261300Medicaid
MIF48177Medicare UPIN
MI0N21050Medicare PIN