MICHIGAN VASCULAR ACCESS, PC (NPI# 1609077783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609077783 |
| Entity Type | Organization |
| Organization Name | MICHIGAN VASCULAR ACCESS, PC |
| Practice Address |
21701 W 11 Mile Rd Southfield MI 48076-3713 |
| Practice Telephone | 2483551100 |
| Mailing Telephone | 2483551100 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2019-03-06 |
| Authorized Official Name | MARC WEBB (PRESIDENT) |
| Authorized Official Telephone | 2483551100 |
| Authorized Official Credential | M D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MW051199 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSE | MW051199 | 01 |
| MI | 4697091 | 05 |
| Street Address |
21701 W 11 MILE RD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48076-3713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083672968 | Marc Gregory Webb | Surgery | 21701 W 11 Mile Rd, Southfield, MI 48076-3713 | 2006-05-02 |
| 1255648077 | John Eric Gibson | Chiropractor | 21701 W 11 Mile Rd, Ste# 12, Southfield, MI 48076-3713 | 2010-09-01 |
| 1023206828 | Brand Orthopedics and Shoe Services, Inc. | Prosthetic/Orthotic Supplier | 21701 W 11 Mile Rd, Suite 2, Southfield, MI 48076-3713 | 2007-10-07 |
| 1093823163 | Gary John Warr | Dentist | 21701 W 11 Mile Rd, Suite 1, Southfield, MI 48076 | 2006-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813753 | Elaine Sarah Kahn | Social Worker | 15999 West Twelve Mile Rd, Southfield, MI 48076 | 2020-08-31 |
| 1295353829 | Marian Hannah Ibrahim | Dentist | 19189 W 12 Mile Rd, Lathrup Village, MI 48076 | 2020-07-09 |
| 1699317669 | Meadow Lane Rehabilitative Therapies LLC | Social Worker | 29895 Greenfield Rd., Suite 104b, Southfield, MI 48076 | 2019-10-11 |
| 1760035752 | Taliah Laneice Williams-hunter | Counselor | 30119 Sparkleberry Dr., Southfield, MI 48076 | 2019-07-19 |
| 1386114742 | Mavis Gail Pookrum | Technician | 21732 Colony Park Circle #105, Southfield, MI 48076 | 2018-11-28 |
| 1861962417 | Millennial Infusion Centers Inc | Clinic/Center | 26250 Northwestern Hwy Ste 201, Southfield, MI 48076 | 2018-11-27 |
| 1215429212 | Debra Deanes | Counselor | 30233 Southfiels Rd, 203, Southfield, MI 48076 | 2018-06-05 |
| 1437675758 | Kenneth Gerard Giles | Counselor | 29532 Southfield Rd. Suite 208, Southfield, MI 48076 | 2017-08-17 |
| 1902346836 | Linsk Psychiatry Services P C | Clinic/Center | 21751 W 12 Mile Rd, Suite 205, Southfield, MI 48076 | 2017-02-25 |
| 1023552361 | Massage Serenity | Community/Behavioral Health | 20245 W. 12 Mile Rd, Suite 113, Southfield, MI 48076 | 2016-12-06 |
| Find all providers in zip 48076 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780919936 | Martin A V Tuma Md Vascular Surgery Pllc | Surgery | 22255 Greemfield Road #250, Southfield, MI 48075 | 2009-10-06 |
| 1083672968 | Marc Gregory Webb | Surgery | 21701 W 11 Mile Rd, Southfield, MI 48076-3713 | 2006-05-02 |
| 1447878160 | Usa Vein Clinics of Detroit Pllc | Surgery | 29984 Telegraph Rd, Southfield, MI 48034-1355 | 2020-07-09 |
| 1235442732 | Pritham P. Reddy, Pllc | Surgery | 22250 Providence Drive, Suite #555, Southfield, MI 48152 | 2010-07-26 |
| 1922266808 | Wound Care Clinics of America PC | Surgery | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2008-05-28 |
| 1134332919 | Pritham Pingli Reddy | Surgery | 22250 Providence Dr, Suite 555, Southfield, MI 48075-4825 | 2007-05-08 |
| 1215967872 | John W Sealey | Surgery | 16250 Northland Dr, Suite 310, Southfield, MI 48075-5205 | 2006-07-03 |
| 1235165770 | Victor Ubom | Surgery | 24111 Southfield Rd, Southfield, MI 48075-2817 | 2006-06-25 |
| 1679525539 | Tamer Nady Boules | Surgery | 22250 Providence Dr, Suite 555, Southfield, MI 48075-4825 | 2006-05-17 |
| 1871560979 | Kevin David Nolan | Surgery | 22250 Providence Dr, Suite 555, Southfield, MI 48075-4825 | 2006-03-07 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48076 |
Please comment or provide details below to improve the information on MICHIGAN VASCULAR ACCESS, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.