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General NPI Number Information
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NPI Number | 1497608558
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIVERSITY OF MICHGIAN
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 39901 TRADITIONS DR
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City | NORTHVILLE
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State | MI
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Zip | 48168-9493
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Country | US
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Telephone | 734-936-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 3621 S STATE ST
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City | ANN ARBOR
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State | MI
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Zip | 48108-1633
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER PROVIDER ENROLLMENT
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Name | MICHELLE KAIKKONEN
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Credential |
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Telephone | 734-936-9610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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