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General NPI Number Information
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NPI Number | 1396742367
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Entity Type | Individual
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Provider Name | VLADIMIR LIPOVETSKY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 2311 E STADIUM BLVD STE 208
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City | ANN ARBOR
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State | MI
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Zip | 48104-4803
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Country | US
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Telephone | 310-846-7390
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Fax |
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Provider Business Mailing Address
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Address Line | 2311 E STADIUM BLVD STE 208
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City | ANN ARBOR
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State | MI
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Zip | 48104-4803
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Country | US
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Telephone | 310-846-7390
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Fax | 818-583-1787
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G77605
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License Number State | CA
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