Provider Demographics
NPI:1487738217
Name:MIGDALEWICZ, ALAN LEE (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LEE
Last Name:MIGDALEWICZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 PINGREE AVE
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-1156
Mailing Address - Country:US
Mailing Address - Phone:248-477-3977
Mailing Address - Fax:248-855-4447
Practice Address - Street 1:31224 MULFORDTON ST
Practice Address - Street 2:SUITE 210B
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1408
Practice Address - Country:US
Practice Address - Phone:248-477-3977
Practice Address - Fax:248-855-4447
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAM006671111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950F322660OtherBCBS
MI4792751Medicaid
MI950F322660OtherBCBS
MIT86581Medicare UPIN