Healthcare Provider Details

I. General information

NPI: 1629367982
Provider Name (Legal Business Name): ANDREW GUAN-HAO TSAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 04/05/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 MACK AVE FL 5
DETROIT MI
48201
US

IV. Provider business mailing address

311 MACK AVE FL 5
DETROIT MI
48201-2466
US

V. Phone/Fax

Practice location:
  • Phone: 313-832-0500
  • Fax: 313-966-8400
Mailing address:
  • Phone: 313-832-0500
  • Fax: 313-966-8400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number4301113309
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number4301113309
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: