Healthcare Provider Details

I. General information

NPI: 1659876878
Provider Name (Legal Business Name): BRIAN SWINDELL DESMOND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 PAULINE BLVD
ANN ARBOR MI
48103-5001
US

IV. Provider business mailing address

5200 VENTURE DR
ANN ARBOR MI
48108-9561
US

V. Phone/Fax

Practice location:
  • Phone: 734-926-4900
  • Fax: 614-635-1290
Mailing address:
  • Phone: 734-971-1073
  • Fax: 734-773-1833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2019-02676
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: