MEDICARE: DR. TOANH POPP M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	4301074367	MI

General Provider Information

NPI Number	:	1265400790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TOANH POPP M.D.

Provider Business Mailing Address
First Line	:	24 FRANK LLOYD WRIGHT DR
Second Line	:	PO BOX 0446 LOBBY J
City	:	ANN ARBOR
State	:	MI
Zip	:	48105-9484
Country	:	US
Telephone Number	:	734-747-6766
Fax Number	:	734-222-3100

Provider Business Practice Location Address
First Line	:	4936 W CLARK RD
Second Line	:	BUILDING D, SUITE 100
City	:	YPSILANTI
State	:	MI
Zip	:	48197-0861
Country	:	US
Telephone Number	:	734-434-6200
Fax Number	:	734-434-7373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	10/12/2016

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