Provider Demographics
NPI:1710412671
Name:MIKHAIL, MIKEL (MD)
Entity Type:Individual
Prefix:
First Name:MIKEL
Middle Name:
Last Name:MIKHAIL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:39650 ORCHARD HILL PL
Mailing Address - Street 2:STE 200
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5391
Mailing Address - Country:US
Mailing Address - Phone:248-319-0161
Mailing Address - Fax:248-319-0170
Practice Address - Street 1:3555 W 13 MILE RD
Practice Address - Street 2:STE LL-20
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-288-2280
Practice Address - Fax:248-288-5644
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2018-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301111662207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology