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Individual

DR. TODD B PROCTOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2251 N SQUIRREL RD, SUITE 105, AUBURN HILLS, MI 48326-4600
(248) 648-8100
(248) 648-8060
Mailing address
2251 N SQUIRREL RD, SUITE 105, AUBURN HILLS, MI 48326-4600
(248) 648-8100
(248) 648-8060

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301054694
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040631293
BCBSM
01
0M23890
MEDICARE GROUP #
MI
05
3394295
MI
Enumeration date
11/16/2005
Last updated
02/28/2018
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