Provider Demographics
NPI:1992960751
Name:MAY M ANTONE MD PC
Entity type:Organization
Organization Name:MAY M ANTONE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-440-2185
Mailing Address - Street 1:29275 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034
Mailing Address - Country:US
Mailing Address - Phone:248-423-7000
Mailing Address - Fax:248-423-7077
Practice Address - Street 1:29275 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1044
Practice Address - Country:US
Practice Address - Phone:248-423-7000
Practice Address - Fax:248-423-7077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073058207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4829350Medicaid
MI4829350Medicaid
MI0P28500Medicare PIN