Provider Demographics
NPI:1922249366
Name:NEPHROLOGY ASSOCIATES OF MICHIGAN PC
Entity Type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF MICHIGAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TABETHA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-712-3132
Mailing Address - Street 1:5333 MCAULEY DR
Mailing Address - Street 2:STE 4003
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197
Mailing Address - Country:US
Mailing Address - Phone:734-712-3470
Mailing Address - Fax:734-712-2935
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:STE 4003
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:734-712-3470
Practice Address - Fax:734-712-2935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty