Individual
MICHAEL I GHILEZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
70 FULTON ST, PONTIAC, MI 48341-2755
(248) 338-0300
(248) 338-0663
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
4301079938
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01044465
HEALTH PLUS OF MICHIGAN THRU OAKLAND PHYSICIANS NETWORK SERVICES (OPNS)
MI
01
—
202490
UNITED HEALTHCARE COMMUNITY PLAN
MI
01
—
320F362430
BCBSM
MI
01
—
41719
HEALTH PLAN OF MICHIGAN
MI
05
—
4535709
—
MI
01
—
7032547
COFINITY
MI
01
—
P01013937
RAILROAD MEDICARE
MI
Enumeration date
03/21/2006
Last updated
01/24/2022
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