# ANN ARBOR VA

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

## Provider details

- **NPI number:** 1841636149
- **Authorized official:** TYKISHA PHELAN (DEPENDENT CREDENTIALING COORDINATOR)
- **Authorized official phone:** (734) 845-3988

## Contact information

- **Practice address:** 2215 FULLER RD, ANN ARBOR, MI 48105-2303
- **Practice address phone:** (734) 845-3988
- **Mailing address:** 2215 FULLER RD, ANN ARBOR, MI 48105-2303
- **Mailing address phone:** (734) 845-3988

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | 4703111463 | MI | Yes |

## Other

- **Enumeration date:** 05/14/2013
- **Last updated:** 05/14/2013