# CVM OF MICHIGAN PLLC

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

## Provider details

- **NPI number:** 1487285227
- **Authorized official:** JAKIA LEWIS (DIRECTOR OF REVENUE CYCLE MNGMNT)
- **Authorized official phone:** (301) 982-2000

## Contact information

- **Practice address:** 6801 ALLEN RD, ALLEN PARK, MI 48101-2007
- **Practice address phone:** (301) 982-2000
- **Mailing address:** 7474 GREENWAY CENTER DR STE 900, GREENBELT, MD 20770-3504
- **Mailing address phone:** (301) 982-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/30/2020
- **Last updated:** 09/04/2020