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Individual

DR. HENRY W. MAICKI

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
24353 ORCHARD LAKE RD, SUITE E, FARMINGTON HILLS, MI 48336-1917
(248) 471-4777
(248) 477-1613
Mailing address
24353 ORCHARD LAKE RD, SUITE E, FARMINGTON HILLS, MI 48336-1917
(248) 471-4777
(248) 477-1613

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
HM026513
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0632414
BLUE CROSS BLUE SHIELD
MI
01
102619
CARE CHOICES HMO
MI
01
148134
GREAT LAKES HEALTH PLAN
05
4359002
MI
01
4398521
AETNA
01
C4990
M CARE
MI
Enumeration date
03/03/2006
Last updated
07/08/2007
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