Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michigan Medical Clinics

Organization Sports Medicine (Neuromusculoskeletal Medicine) Physician · NPI 1104206978

Michigan Medical Clinics is a Sports Medicine (Neuromusculoskeletal Medicine) Physician in Southfield, Michigan. Licensed in Michigan. Registered with an NPI since 2015.

Licensed in
MI
In the registry since
2015
Specialties on file
4

Practice location Address checks out

29984 Telegraph Rd Ste A
Southfield, MI 48034-1355
Phone: (248) 933-1224
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician Taxonomy 204C00000X · Licence 4301094678 (MI)
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician Taxonomy 207PE0005X
Urgent Care Clinic/Center Taxonomy 261QU0200X

Record details

NPI number1104206978
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alex Olkhovsky — Chairman Of The Board Of Directors · (248) 933-1224
NPI enumeratedJune 5, 2015
Last updated in NPPESMarch 11, 2016
Mailing address2601 Kingstowne Dr, Commerce Twp, MI 48390-2712

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