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General NPI Number Information
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NPI Number | 1669512786
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIV OF MICHIGAN- AMBULATORY CTR FOR VEIN TREATMENT
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 19900 HAGGERTY RD SUITE 105
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City | LIVONIA
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State | MI
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Zip | 48152-1053
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Country | US
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Telephone | 734-432-7662
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Fax |
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Provider Business Mailing Address
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Address Line | 3621 S STATE ST 700 KMS PLACE
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City | ANN ARBOR
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State | MI
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Zip | 48108
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Country | US
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Telephone | 734-936-2047
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Fax |
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Authorized Official
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Title or Position | EXEC MEDICAL DIRECTOR FACULTY GROUP
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Name | DAVID A SPAHLINGER
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Credential | MD
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Telephone | 734-936-3568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State | MI
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Taxonomy #3
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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 | MI
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