Provider Demographics
NPI:1104800986
Name:MARGOLIS, HAROLD (DO)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:
Last Name:MARGOLIS
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 1:27301 DEQUINDRE RD
Mailing Address - Street 2:STE 314
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071
Mailing Address - Country:US
Mailing Address - Phone:248-399-4400
Mailing Address - Fax:248-399-4840
Practice Address - Street 1:27301 DEQUINDRE RD
Practice Address - Street 2:STE 314
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071
Practice Address - Country:US
Practice Address - Phone:248-399-4400
Practice Address - Fax:248-399-4840
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101005779207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4385488-11Medicaid
MI4385488-11Medicaid
5633018Medicare ID - Type Unspecified