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Organization
REGENTS OF THE UNIVERSITY OF MICHIGAN ORAL PATHOLOGY
Active
Organization
REGENTS OF THE UNIVERSITY OF MICHIGAN ORAL PATHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NISHA J. D'SILVA DDS PHS (LABORATORY DIRECTOR)
(734) 764-1543
Entity
Organization
Contact information
Practice address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 764-1543
(734) 764-2469
Mailing address
4251 PLYMOUTH RD, BUILDING 3 SUITE 2400, ANN ARBOR, MI 48109-2789
(734) 647-8091
(734) 647-8090
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027740
MIDWEST HEALTH
MI
01
—
190H110650
BCBS OF MI MED SURGICAL
MI
01
—
DD81014
M-CARE
MI
01
—
QMXPR0013422
MOLINA HEALTHCARE OF MI
MI
01
—
XX20091
HEALTH PLUS OF MI
MI
Enumeration date
03/20/2007
Last updated
02/04/2014
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