Healthcare Provider Details

I. General information

NPI: 1942198007
Provider Name (Legal Business Name): MARY BUZZARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 W HURON ST STE 1
ANN ARBOR MI
48103-4200
US

IV. Provider business mailing address

708 W HURON ST STE 1
ANN ARBOR MI
48103-4200
US

V. Phone/Fax

Practice location:
  • Phone: 734-224-9272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851118752
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: