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Individual

TIMOTHY P PAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
800 S ADAMS RD, SUITE 201, BIRMINGHAM, MI 48009-7005
(248) 644-8060
(248) 644-5081
Mailing address
800 S ADAMS RD, SUITE 201, BIRMINGHAM, MI 48009-7005
(248) 644-8060
(248) 644-5081

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
TP063398
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0F37296
BCBSM
MI
01
0F37296005
RAILROAD MEDICARE
01
180F372960
BLUE CARE NETWORK
01
381867275
PPOM
05
4179882
MI
01
C6939
MCARE
01
G76707
HAP
Enumeration date
09/07/2005
Last updated
10/27/2020
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