Organization
ANN ARBOR VA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYKISHA PHELAN (DEPENDENT CREDENTIALING COORDINATOR)
(734) 845-3988
Entity
Organization
Contact information
Practice address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
(734) 845-3988
Mailing address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
(734) 845-3988
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
4703111463
MI
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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