Healthcare Provider Details

I. General information

NPI: 1598703894
Provider Name (Legal Business Name): ANDREW F CAUGHEY III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 HOGBACK RD SUITE 5
ANN ARBOR MI
48105-9750
US

IV. Provider business mailing address

3 HEATHERRIDGE
ANN ARBOR MI
48104
US

V. Phone/Fax

Practice location:
  • Phone: 734-786-4940
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301050970
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: