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General NPI Number Information
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NPI Number | 1285339408
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Entity Type | Organization
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Legal Business Name | A&A VASCULAR, PLLC
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 37504 7 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48152-1004
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Country | US
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Telephone | 734-744-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 37504 7 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48152-1004
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Country | US
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Telephone | 734-744-4100
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | ROBIN FOX
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Credential |
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Telephone | 248-568-8280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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