# MICHIGAN VASCULAR ACCESS, PC

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

## Provider details

- **NPI number:** 1609077783
- **Authorized official:** MARC WEBB M D (PRESIDENT)
- **Authorized official phone:** (248) 355-1100

## Contact information

- **Practice address:** 21701 W 11 MILE RD, SOUTHFIELD, MI 48076-3713
- **Practice address phone:** (248) 355-1100
- **Mailing address:** 21701 W 11 MILE RD, SOUTHFIELD, MI 48076-3713
- **Mailing address phone:** (248) 355-1100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | MW051199 | MI | Yes |

## Other

- **Enumeration date:** 05/29/2007
- **Last updated:** 03/06/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4697091 | — | MI |
| 01 | — | MW051199 | STATE LICENSE | MI |