Provider Demographics
NPI:1861421380
Name:WIND, MICHAEL F (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:F
Last Name:WIND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13350 24 MILE RD
Mailing Address - Street 2:STE 700
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-1827
Mailing Address - Country:US
Mailing Address - Phone:586-469-8300
Mailing Address - Fax:
Practice Address - Street 1:21620 HARRINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-2319
Practice Address - Country:US
Practice Address - Phone:586-469-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011018207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3395022Medicaid
MI3395022Medicaid
MIG31432Medicare UPIN