Provider Demographics
NPI:1053395889
Name:BICOS, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BICOS
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 1:24255 W 13 MILE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4320
Mailing Address - Country:US
Mailing Address - Phone:248-988-8085
Mailing Address - Fax:248-988-8565
Practice Address - Street 1:24255 W 13 MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4320
Practice Address - Country:US
Practice Address - Phone:248-988-8085
Practice Address - Fax:248-988-8565
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301101981207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000373188OtherBCBS
IN2555477OtherUHC
IN200257130Medicaid
IN7453736OtherAETNA
IN177100PMedicare ID - Type Unspecified
IN7453736OtherAETNA