Provider Demographics
NPI:1629043955
Name:SIKORSKY, MICHAEL H (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:SIKORSKY
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 1:359 ENTERPRISE CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1055
Mailing Address - Country:US
Mailing Address - Phone:248-751-7246
Mailing Address - Fax:248-418-2311
Practice Address - Street 1:359 ENTERPRISE CT
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-1055
Practice Address - Country:US
Practice Address - Phone:248-751-7246
Practice Address - Fax:248-418-2311
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013580207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H75241Medicare UPIN
MIOF36192064Medicare ID - Type Unspecified