Provider Demographics
NPI:1568537462
Name:SORSCHER, IRVING MICHAEL (DDS)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:MICHAEL
Last Name:SORSCHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6664 ORCHARD LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3402
Mailing Address - Country:US
Mailing Address - Phone:248-851-5630
Mailing Address - Fax:248-851-5632
Practice Address - Street 1:6664 ORCHARD LAKE ROAD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3402
Practice Address - Country:US
Practice Address - Phone:248-851-5630
Practice Address - Fax:248-851-5632
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901009097122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1956314860OtherMEDICAL PROVIDER BLUE CRO