# PEDIATRIC NEPHROLOGY ASSOCIATES OF MICHIGAN PLC

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

## Provider details

- **NPI number:** 1730320177
- **Authorized official:** OLGA BLANEY (PRATICE MANAGER)
- **Authorized official phone:** (734) 712-3471

## Contact information

- **Practice address:** 5333 MCAULEY DRIVE, SUITE 4003, YPSILANTI, MI 48197-1099
- **Practice address phone:** (734) 712-3888
- **Mailing address:** 5333 MCAULEY DRIVE, SUITE 4003, YPSILANTI, MI 48197-1099
- **Mailing address phone:** (734) 712-3888

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0210X | Pediatric Nephrology Physician | — | NULL | Yes |
| 2080P0210X | Pediatric Nephrology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/16/2009
- **Last updated:** 03/31/2009