Provider Demographics
NPI:1750417655
Name:DAY, MICHELLE TANG (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:TANG
Last Name:DAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:TANG
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6530 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3216
Mailing Address - Country:US
Mailing Address - Phone:248-661-8220
Mailing Address - Fax:248-661-3500
Practice Address - Street 1:6530 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3216
Practice Address - Country:US
Practice Address - Phone:248-661-8220
Practice Address - Fax:248-661-3500
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2020-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-221084208000000X
MI4301501339208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0001982Medicare PIN