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Organization

REGENTS OF THE UNIVERSITY OF MICHIGAN - AMBULATORY CTR FOR VEIN TRTMT

Active
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Organization

REGENTS OF THE UNIVERSITY OF MICHIGAN - AMBULATORY CTR FOR VEIN TRTMT

Active
Parent organization
REGENTS OF THE UNIVERSITY OF MICHIGAN
Organization subpart
Yes

Provider details

NPI number
Legal business name
REGENTS OF THE UNIVERSITY OF MICHIGAN
Authorized official
DAVID A SPAHLINGER MD (EXEC MEDICAL DIRECTOR FACULTY GRP)
(734) 936-3568
Entity
Organization

Contact information

Practice address
19900 HAGGERTY RD, SUITE 105, LIVONIA, MI 48152-1054
(734) 432-7811
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MI
363AM0700X
Medical Physician Assistant
MI
363AS0400X
Surgical Physician Assistant
MI

Other

Enumeration date
12/02/2013
Last updated
03/06/2014
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