# BLOOMFIELD VEIN & VASCULAR PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013309988
- **Authorized official:** DR. DIEGO HERNANDEZ M.D (OWNER)
- **Authorized official phone:** (419) 794-1006

## Contact information

- **Practice address:** 43700 WOODWARD AVE STE 207, BLOOMFIELD HILLS, MI 48302-5061
- **Practice address phone:** (419) 794-1006
- **Practice address fax:** (419) 873-6599
- **Mailing address:** 43700 WOODWARD AVE STE 207, BLOOMFIELD HILLS, MI 48302-5061
- **Mailing address phone:** (419) 794-1006
- **Mailing address fax:** (419) 873-6599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/02/2015
- **Last updated:** 03/02/2015