Provider Demographics
NPI:1073509857
Name:EHRLICH, WILLIAM W (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30150 TELEGRAPH RD STE 271
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4521
Mailing Address - Country:US
Mailing Address - Phone:313-530-5494
Mailing Address - Fax:205-943-4660
Practice Address - Street 1:19176 HALL RD STE 110
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6914
Practice Address - Country:US
Practice Address - Phone:586-286-3400
Practice Address - Fax:862-863-6195
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301043309207WX0200X
FLME126065207W00000X
ALMD.43248207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016026200Medicaid
FLMGXP0OtherBC FLORIDA
FLP01599482OtherRAIL ROAD MEDICARE
FLII830YMedicare PIN
FLII830ZMedicare PIN
FLII830ZMedicare PIN
FLMGXP0OtherBC FLORIDA
MIA74882Medicare UPIN
MI180028406OtherRAILROAD MEDICARE
FLII830YMedicare PIN