Healthcare Provider Details

I. General information

NPI: 1568671972
Provider Name (Legal Business Name): ALLERGY & IMMUNOLOGY ASSOCIATES OF ANN ARBOR, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N HURON RIVER DR STE 200
YPSILANTI MI
48197-1791
US

IV. Provider business mailing address

4350 JACKSON RD STE 370
ANN ARBOR MI
48103-1889
US

V. Phone/Fax

Practice location:
  • Phone: 734-434-3007
  • Fax: 734-434-6317
Mailing address:
  • Phone: 734-434-3007
  • Fax: 734-434-6317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number4301035591
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number4301035591
License Number StateMI

VIII. Authorized Official

Name: JEFFREY G. LEFLEIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 734-434-3007