Individual
MICHAEL ANDREW MICHELAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301060055
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260410522
BC/BS
MI
05
—
3279490
—
MI
Enumeration date
05/31/2006
Last updated
03/26/2025
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