Organization
PARK PLACE VEIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN BRYAN NEWMAN M.D. (OWNER)
(248) 465-4762
Entity
Organization
Contact information
Practice address
47601 GRAND RIVER AVE, SUITE A-110, NOVI, MI 48374-1233
(248) 465-4762
Mailing address
3802 SPANISH OAKS DR, WEST BLOOMFIELD, MI 48323-1859
(248) 465-4762
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
AN 067888
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4495597
—
MI
Enumeration date
07/04/2006
Last updated
08/22/2020
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