Organization
MICHIGAN VASCULAR ACCESS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC WEBB M D (PRESIDENT)
(248) 355-1100
Entity
Organization
Contact information
Practice address
21701 W 11 MILE RD, SOUTHFIELD, MI 48076-3713
(248) 355-1100
Mailing address
21701 W 11 MILE RD, SOUTHFIELD, MI 48076-3713
(248) 355-1100
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MW051199
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4697091
—
MI
01
—
MW051199
STATE LICENSE
MI
Enumeration date
05/29/2007
Last updated
03/06/2019
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