Individual
DR. MICHAEL NITHIPHAISAL YU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-6137
Mailing address
DEPT CH 17767, PALATINE, IL 60055-7767
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34C.000532
OH
207P00000X
Emergency Medicine Physician
5101013110
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101013110
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4253175
—
MI
05
—
4253184
—
MI
05
—
4253193
—
MI
01
—
930109721
RAILROAD MEDICARE
—
01
—
MY013110
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/23/2005
Last updated
10/23/2025
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