Healthcare Provider Details

I. General information

NPI: 1801983655
Provider Name (Legal Business Name): HENRY ALEXANDER ARTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 MCAULEY DR RM 2017
YPSILANTI MI
48197-1096
US

IV. Provider business mailing address

5333 MCAULEY DR RM 2017
YPSILANTI MI
48197-1096
US

V. Phone/Fax

Practice location:
  • Phone: 734-434-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number4301062152
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number39186
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number39186
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number4301062152
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: