Provider Demographics
NPI:1437134533
Name:SILLS, MICHAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:SILLS
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 1:6116 BRIGGS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-9563
Mailing Address - Country:US
Mailing Address - Phone:248-425-1102
Mailing Address - Fax:248-425-1102
Practice Address - Street 1:6116 BRIGGS LAKE DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-9563
Practice Address - Country:US
Practice Address - Phone:248-425-1102
Practice Address - Fax:248-425-1102
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-12
Last Update Date:2025-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048897207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI06317711OtherBCBS INDIVIDUAL
MI1437134533Medicaid
MIB44648OtherHAP
MI110246812OtherRR MEDICARE
MI700H273300OtherBLUE SHIELD
MI06317711OtherBCBS INDIVIDUAL
MIB44648OtherHAP
MI0N65510-001Medicare ID - Type Unspecified