Individual
DR. BRIAN THOMAS MICHALSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6998 REDANSA DR, ROCKFORD, IL 61108-4378
(815) 971-2000
(815) 971-9620
Mailing address
601 JOHN STREET, BOX 42, KALAMAZOO, MI 49007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-126596
IL
207Q00000X
Family Medicine Physician
Primary
5101027951
MI
207QS0010X
Sports Medicine (Family Medicine) Physician
036126596
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
5101027951
MI
Other
Enumeration date
08/03/2008
Last updated
08/06/2024
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