Individual
DR. MICHAEL ROBERT ISRAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18181 OAKWOOD BLVD STE 212, DEARBORN, MI 48124-5031
(313) 438-7397
(313) 438-7398
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1863
(047) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301044171
MI
2086S0129X
Vascular Surgery Physician
4301044171
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02-0822061-1
BCBSM INDIVIDUAL PIN#
MI
01
—
020H263670
BCBSM GROUP PIN#
MI
05
—
4235319
—
MI
01
—
B9840
MCARE INDIVIDUAL PIN#
MI
Enumeration date
02/08/2006
Last updated
10/23/2020
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