Individual
DR. MICHAEL S FOZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21000 E 12 MILE RD, SUITE 111, SAINT CLAIR SHORES, MI 48081-1116
(586) 779-7610
Mailing address
21000 E 12 MILE RD, STE 111, ST CLAIR SHORES, MI 48081
(586) 779-7610
(586) 445-2523
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
MF075562
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0501379
BLUE CARE NETWORK
—
01
—
136815
CARE CHOICES
—
01
—
141736
GREAT LAKES HEALTH PLAN
—
01
—
16056
MCAR
—
01
—
4339229
AETNA
—
05
—
4505853
—
MI
01
—
6029816
CIGNA
—
01
—
H68407
HEALTH ALLIANCE PLAN
—
01
—
P00014677
RAILROAD MEDICARE
—
Enumeration date
09/29/2006
Last updated
10/05/2007
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