Healthcare Provider Details

I. General information

NPI: 1396162350
Provider Name (Legal Business Name): UNIVERSITY OF MICHGAN HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E MEDICAL CENTER DR
ANN ARBOR MI
48109-5000
US

IV. Provider business mailing address

1500 E MEDICAL CENTER DR
ANN ARBOR MI
48109-5000
US

V. Phone/Fax

Practice location:
  • Phone: 734-232-5756
  • Fax:
Mailing address:
  • Phone: 734-232-5756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number1601000662
License Number StateMI

VIII. Authorized Official

Name: DR. JAYNEE HANDELSMAN
Title or Position: DIRECTOR, PEDIATRIC AUDIOLOGY
Credential: PH.D.
Phone: 734-036-9415