Provider Demographics
NPI:1457357915
Name:SOLOMON, MICHAEL HUGH (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HUGH
Last Name:SOLOMON
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 1:5333 MCAULEY DR
Mailing Address - Street 2:RM 3001
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1097
Mailing Address - Country:US
Mailing Address - Phone:734-712-8100
Mailing Address - Fax:734-712-8112
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:RM 3001
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1097
Practice Address - Country:US
Practice Address - Phone:734-712-8100
Practice Address - Fax:734-712-8112
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMS039211208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI103502OtherCARE CHOICES
MI340H110900OtherBCBSM
MI340H110900OtherBLUE CARE NETWORK
MI383461163003OtherCIGNA
MI4147000Medicaid
MI002145OtherMIDWEST
MI340017147OtherRR MEDICARE UNITED HEALTH
MI103502OtherPREFERRED CHOICES
MI340H110900OtherBLUE CARE NETWORK
MI4147000Medicaid