Provider Demographics
NPI:1821068529
Name:PAD, MICHAEL SAMUEL (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SAMUEL
Last Name:PAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:441 SOUTH LIVERNOIS
Mailing Address - Street 2:SUITE 190
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-656-9443
Mailing Address - Fax:248-656-5751
Practice Address - Street 1:1101 W UNIVERSITY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-652-5000
Practice Address - Fax:248-652-5407
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101009041207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F22563Medicare UPIN
F36094008Medicare ID - Type Unspecified