Individual
DR. MICHAEL JONATHAN SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
42505 WOODWARD AVE., SUITE 103, BLOOMFIELD HILLS, MI 48304-5147
(248) 334-6200
(248) 334-3660
Mailing address
42505 WOODWARD AVE., SUITE 103, BLOOMFIELD HILLS, MI 48304-5147
(248) 334-6200
(248) 334-3660
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301029412
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0638423
BLUE CROSS,OTHER INSURACE
MI
05
—
1065073-10-0
—
MI
Enumeration date
12/14/2006
Last updated
09/27/2011
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