Healthcare Provider Details

I. General information

NPI: 1760945661
Provider Name (Legal Business Name): AN VO NHU CAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11780 TELEGRAPH RD STE 100
TAYLOR MI
48180-6862
US

IV. Provider business mailing address

11780 TELEGRAPH RD STE 100
TAYLOR MI
48180-6862
US

V. Phone/Fax

Practice location:
  • Phone: 734-374-1112
  • Fax: 734-374-1119
Mailing address:
  • Phone: 734-374-1112
  • Fax: 734-374-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301512907
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: