Axalan G Axalan, Physical Therapist
Physical Therapist in Saint Clair Shores, MI. Individual provider (NPI-1).
NPI number1780174607
StatusActive
Last updated in NPPESJun 16, 2018
Details
- NPI
- 1780174607
- Entity type
- Individual (NPI-1)
- Name
- Axalan G Axalan
- Credential
- Physical Therapist
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 16, 2018
- Last updated
- Jun 16, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 5501014604 | MI | Yes |
Practice location
26001 Jefferson AveSaint Clair Shores, MI 48081-2309
Phone 586-779-7000
Mailing address
2630 Union Lake RdCommerce Township, MI 48382-3582
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 76 Physical Therapist providers in Saint Clair Shores · All 1,725 providers in Saint Clair Shores
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