Provider Demographics
NPI:1568550291
Name:VENTURA, MICHAEL S (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:VENTURA
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Gender:M
Credentials:DO
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Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:4200 WHITEHALL DR
Practice Address - Street 2:SUITE 150
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105
Practice Address - Country:US
Practice Address - Phone:734-995-0308
Practice Address - Fax:248-334-2250
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2022-06-23
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Provider Licenses
StateLicense IDTaxonomies
MI5101011769207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F67652Medicare UPIN