# REGENTS OF THE UNIVERSITY OF MICHIGAN-PEDIATRIC SURGERY OFFSITE

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

## Provider details

- **NPI number:** 1821241951
- **Authorized official:** DAVID A SPAHLINGER MD (EXEC MEDICAL DIRECTOR FACULTY GRP)
- **Authorized official phone:** (734) 936-3568

## Contact information

- **Practice address:** 4642 GENESYS PARKWAY, GRAND BLANC, MI 48439-8067
- **Practice address phone:** (810) 606-5830
- **Mailing address:** 3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
- **Mailing address phone:** (734) 936-2047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080P0201X | Pediatric Allergy/Immunology Physician | — | NULL | — |
| 2080P0201X | Pediatric Allergy/Immunology Physician | — | — | — |
| 2080P0214X | Pediatric Pulmonology Physician | — | NULL | Yes |
| 2080P0214X | Pediatric Pulmonology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/03/2008
- **Last updated:** 11/03/2008