Provider Demographics
NPI:1871991943
Name:HIRAGA, MIKIO H (MD)
Entity type:Individual
Prefix:DR
First Name:MIKIO
Middle Name:H
Last Name:HIRAGA
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 1:4801 DORAL DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-8536
Mailing Address - Country:US
Mailing Address - Phone:734-994-0338
Mailing Address - Fax:
Practice Address - Street 1:4801 DORAL DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-8536
Practice Address - Country:US
Practice Address - Phone:734-994-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301023775207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology