Healthcare Provider Details

I. General information

NPI: 1851974257
Provider Name (Legal Business Name): MARGARETE ARYANKA WALLNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 PLYMOUTH RD
ANN ARBOR MI
48109-2700
US

IV. Provider business mailing address

530 LIBERTY POINTE DR
ANN ARBOR MI
48103-6806
US

V. Phone/Fax

Practice location:
  • Phone: 734-764-0231
  • Fax: 734-763-5580
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4351055537
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: