Provider Demographics
NPI:1801870654
Name:MAY, BOB STUDLEY (DO)
Entity type:Individual
Prefix:
First Name:BOB
Middle Name:STUDLEY
Last Name:MAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:THOMAS
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 N PERRY ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2217
Mailing Address - Country:US
Mailing Address - Phone:248-338-5327
Mailing Address - Fax:248-338-5129
Practice Address - Street 1:50 N PERRY ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2217
Practice Address - Country:US
Practice Address - Phone:248-338-5327
Practice Address - Fax:248-338-5129
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI510103522207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA316954-11Medicaid
G75485Medicare UPIN
MIA316954-11Medicaid