Provider Demographics
NPI:1295722171
Name:MICHELS, WILLIAM III (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:MICHELS
Suffix:III
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 1:29600 S WIXOM RD
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-3430
Mailing Address - Country:US
Mailing Address - Phone:248-668-1900
Mailing Address - Fax:248-668-1905
Practice Address - Street 1:4929 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48125-2027
Practice Address - Country:US
Practice Address - Phone:313-292-4820
Practice Address - Fax:313-292-4976
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2014-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010990207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3115610-11Medicaid
MI3224061-11Medicaid
MI3229021-11Medicaid
MI3127237-11Medicaid
MIF42348Medicare UPIN
MI3229021-11Medicaid