# DR. MICHAEL TILLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1356306658
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171000000X | Military Health Care Provider | 4301075583 | MI | — |
| 208600000X | Surgery Physician | 4301075583 | MI | — |
| 208600000X | Surgery Physician | MD457338 | PA | — |
| 2086S0102X | Surgical Critical Care Physician | MD457338 | PA | — |
| 2086S0127X | Trauma Surgery Physician | 4301075583 | MI | Yes |

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 04/13/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1356306658 | — | DC |