=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396162350
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNIVERSITY OF MICHGAN HEALTH SYSTEM
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2014
-----------------------------------------------------
Last Update Date | 03/27/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1500 E MEDICAL CENTER DR
-----------------------------------------------------
City | ANN ARBOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48109-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-232-5756
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1500 E MEDICAL CENTER DR
-----------------------------------------------------
City | ANN ARBOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48109-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-232-5756
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR, PEDIATRIC AUDIOLOGY
-----------------------------------------------------
Name | DR. JAYNEE HANDELSMAN
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 734-036-9415
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282NC2000X
-----------------------------------------------------
Taxonomy Name | Children's Hospital
-----------------------------------------------------
License Number | 1601000662
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------