Healthcare Provider Details

I. General information

NPI: 1336729953
Provider Name (Legal Business Name): ALAN AHLAWAT SUMSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E MEDICAL CENTER DRIVE, SPC 5856 VASCULAR SURGERY CLINIC
ANN ARBOR MI
48109-5856
US

IV. Provider business mailing address

1500 E MEDICAL CENTER DRIVE 5346 CVC, SPC 5867
ANN ARBOR MI
48109-5867
US

V. Phone/Fax

Practice location:
  • Phone: 734-936-5850
  • Fax:
Mailing address:
  • Phone: 734-547-9867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301516490
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: