Provider Demographics
NPI:1386089472
Name:SAMLUK, MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SAMLUK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:37637 FIVE MILE RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1216
Mailing Address - Country:US
Mailing Address - Phone:855-850-3278
Mailing Address - Fax:855-228-7175
Practice Address - Street 1:37637 FIVE MILE RD STE 370
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1543
Practice Address - Country:US
Practice Address - Phone:855-850-3278
Practice Address - Fax:855-228-7175
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101020255207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine