Healthcare Provider Details

I. General information

NPI: 1669581997
Provider Name (Legal Business Name): ANESTHESIA ASSOCIATES OF ANN ARBOR, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 06/25/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33545 CHERRY HILL RD FL 2
WESTLAND MI
48186-4842
US

IV. Provider business mailing address

2006 HOGBACK RD STE 5A
ANN ARBOR MI
48105-9750
US

V. Phone/Fax

Practice location:
  • Phone: 313-293-7777
  • Fax:
Mailing address:
  • Phone: 734-263-2395
  • Fax: 734-773-3471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: TRACI COFFMAN
Title or Position: CHAIR
Credential: MD
Phone: 734-263-2400