MICHIGAN VASCULAR ACCESS PC NPI 1609077783

NPI Information

NPI: 1609077783
Provider Name: MICHIGAN VASCULAR ACCESS, PC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

CLIA Number: 23D2006434

Address:
21701 W 11 MILE RD
SOUTHFIELD, MI
ZIP 48076
Phone: (248) 355-1100
Get Directions

MICHIGAN VASCULAR ACCESS, PC is a vascular surgery surgery in Southfield, MI. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. MICHIGAN VASCULAR ACCESS, PC NPI is 1609077783. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

21701 W 11 MILE RD
SOUTHFIELD, MI
ZIP 48076-713
Phone: (248) 355-1100

The provider's authorized official is Marc Webb .
The authorized official title is President and has the following contact phone number (248) 355-1100.

The CLIA number assigned to this NPI record is 23D2006434 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/29/2007 and was last updated on 3/6/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	MW051199	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MW051199	OTHER	MICHIGAN	STATE LICENSE
2	4697091	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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