Michael L. Hicks, MD, PC

Primary specialty

Gynecologic Oncology PhysicianTaxonomy code 207VX0201X

License

4301406967 Issued in MI

Legal business name

MICHAEL L. HICKS, MD, PC

Practice address

44405 Woodward Ave
Gustafson ASC, Suite 202
Pontiac, MI 48341-5023

Phone

(248) 858-2270

Fax

(248) 335-6171

NPI assigned

Aug 16, 2006

Last updated

Mar 20, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Leon Hicks, MDNPI 1194772020

Title

Physician Owner

Phone

(248) 760-2239

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

Michael L Hicks MD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Michael L. Hicks, MD, PC

  • Gynecologic Oncology Physician
  • Pontiac, MI
  • NPI 1134137813
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael L Hicks, MD

  • Gynecologic Oncology Physician
  • Pontiac, MI
  • NPI 1194772020
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1427161306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 287",
            "city": "STOW",
            "state": "MA",
            "postal_code": "017750287",
            "telephone_number": "978-897-4782",
            "fax_number": "978-897-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "address_2": "GUSTAFSON ASC, SUITE 202",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-2270",
            "fax_number": "248-335-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L. HICKS, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "248-760-2239",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MI",
            "license": "4301406967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gynecologic Oncology Physician in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Gynecologic Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.