Healthcare Provider Details

I. General information

NPI: 1144047937
Provider Name (Legal Business Name): ELIZABETH SUZANNE FICHERA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S MAPLE RD
ANN ARBOR MI
48103-3833
US

IV. Provider business mailing address

1301 S MAIN ST
CHELSEA MI
48118-1418
US

V. Phone/Fax

Practice location:
  • Phone: 734-794-3494
  • Fax:
Mailing address:
  • Phone: 734-720-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: