Provider Demographics
NPI:1518086560
Name:DRELLES, MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DRELLES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44200 WOODWARD AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5046
Mailing Address - Country:US
Mailing Address - Phone:248-384-8100
Mailing Address - Fax:248-384-8101
Practice Address - Street 1:44200 WOODWARD AVE STE 112
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5046
Practice Address - Country:US
Practice Address - Phone:248-384-8100
Practice Address - Fax:248-384-8101
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10746207LP2900X
MI5101016093207LP2900X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N37000Medicare PIN