Individual
THEODOROS VLACHOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3535 W 13 MILE RD STE 329, ROYAL OAK, MI 48073-6770
(248) 551-1399
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301054774
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160F376970
BCBSM
MI
05
—
4769978
—
MI
Enumeration date
03/24/2006
Last updated
10/23/2020
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