Individual
ALEXANDRA SELIM THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14700 E OLD US HIGHWAY 12, CHELSEA, MI 48118-1185
(734) 936-7175
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301067486
MI
208100000X
Physical Medicine & Rehabilitation Physician
AT67486
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104217061
—
MI
01
—
127928
CARE CHOICES
—
01
—
250011706
RAILROAD MEDICARE
—
01
—
AT067486
BCBS
—
01
—
DR810358
MCARE
—
Enumeration date
02/12/2007
Last updated
01/24/2024
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