Provider Demographics
NPI:1770072191
Name:FOX, MICHELLE D
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:D
Last Name:FOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:D
Other - Last Name:TORREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:522 SEQUOIA DR
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-1960
Mailing Address - Country:US
Mailing Address - Phone:810-280-2604
Mailing Address - Fax:
Practice Address - Street 1:2284 S BALLENGER HWY STE G
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-3446
Practice Address - Country:US
Practice Address - Phone:810-221-7871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information