Healthcare Provider Details

I. General information

NPI: 1841219037
Provider Name (Legal Business Name): CENTER FOR PLASTIC SURGERY ANN ARBOR, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 MCAULEY DR SUITE R5001
YPSILANTI MI
48197-1014
US

IV. Provider business mailing address

5333 MCAULEY DR SUITE R5001
YPSILANTI MI
48197-1014
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-2323
  • Fax: 734-712-2312
Mailing address:
  • Phone: 734-712-2323
  • Fax: 734-712-2312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBYN NAILOR
Title or Position: ADMINISTRATIVE MANAGER
Credential:
Phone: 734-712-7087