# IHA OLMA SPECIALTY 1 LLC

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

## Provider details

- **NPI number:** 1114667144
- **Authorized official:** CYNTHIA A ELLIOTT (PRESIDENT)
- **Authorized official phone:** (734) 327-0872

## Contact information

- **Practice address:** 36475 FIVE MILE RD, LIVONIA, MI 48154-1971
- **Practice address phone:** (734) 655-2692
- **Practice address fax:** (734) 655-4218
- **Mailing address:** 24 FRANK LLOYD WRIGHT DR STE J2000, ANN ARBOR, MI 48105-9484
- **Mailing address phone:** (734) 747-6766
- **Mailing address fax:** (734) 222-3100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0102X | Surgical Critical Care Physician | — | NULL | Yes |
| 2086S0102X | Surgical Critical Care Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/29/2022
- **Last updated:** 10/09/2023