Provider Demographics
NPI:1629026505
Name:TURNER, MICHAEL S (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:TURNER
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 1:4750 HEMPSTEAD STATION DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5164
Mailing Address - Country:US
Mailing Address - Phone:800-875-0136
Mailing Address - Fax:937-619-4231
Practice Address - Street 1:550 MIRABEAU ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:OH
Practice Address - Zip Code:45123-1617
Practice Address - Country:US
Practice Address - Phone:937-981-2116
Practice Address - Fax:937-981-9238
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059261T207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000344440OtherBCBS
OH0778421Medicaid
P00219563OtherRAILROAD MEDICARE MADISON
P00174088OtherRAILROAD MEDICARE
000000319620OtherBLUE CROSS BLUE SHIELD
OH000000316744OtherBCBS MADISON
OHP00163334OtherMEDICARE RAILROAD
OH0693349Medicare PIN
000000344440OtherBCBS
P00174088OtherRAILROAD MEDICARE
P00219563OtherRAILROAD MEDICARE MADISON