# A&A VASCULAR, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake State Vein and Vascular
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285339408
- **Authorized official:** ROBIN FOX (CREDENTIALING MANAGER)
- **Authorized official phone:** (248) 568-8280

## Contact information

- **Practice address:** 37504 7 MILE RD, LIVONIA, MI 48152-1004
- **Practice address phone:** (734) 744-4100
- **Mailing address:** 37504 7 MILE RD, LIVONIA, MI 48152-1004
- **Mailing address phone:** (734) 744-4100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/05/2023
- **Last updated:** 07/11/2023