Individual
DR. THOMAS J DITKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26025 LAHSER RD, 2ND FLOOR, SOUTHFIELD, MI 48033-2601
(248) 663-1900
(248) 663-1902
Mailing address
26025 LAHSER RD, 2ND FLOOR, SOUTHFIELD, MI 48033-2601
(248) 663-1900
(248) 663-1902
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301030676
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0767220001
ADMINISTAR FEDERAL
MI
01
—
0F31114
BCBS
MI
01
—
0F33583
BCBS DME
MI
05
—
2751179
—
MI
Enumeration date
11/14/2005
Last updated
01/12/2010
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