Healthcare Provider Details

I. General information

NPI: 1104564590
Provider Name (Legal Business Name): BENJAMIN WELD SCHULTZ RANSOM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 EAST ANN STREET SAMUEL AND JEAN FRANKEL CARDIOVASCULAR CENTER
ANN ARBOR MI
48109
US

IV. Provider business mailing address

1500 EAST MEDICAL CENTER DRIVE 1914 TAUBMAN CENTER
ANN ARBOR MI
48109-5000
US

V. Phone/Fax

Practice location:
  • Phone: 888-287-1082
  • Fax:
Mailing address:
  • Phone: 734-764-3673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number81748
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number32700
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301516323
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301516323
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: