1619959400 NPI number — MS. ANNE MARIE DOHRENWEND PHD

Table of content: YU-HSIANG LIANG-PAULTRE O.T. (NPI 1942487517)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619959400 NPI number — MS. ANNE MARIE DOHRENWEND PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOHRENWEND
Provider First Name:
ANNE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619959400
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
904 SPRING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48103-3243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-657-9034
Provider Business Mailing Address Fax Number:
810-342-1590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 E WASHINGTON ST STE 606
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48104-2012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-657-9033
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  6301010100 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC1900X , with the licence number: 6301010100 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 056350 . This is a "VQLUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0985309 . This is a "HEALTH PLUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 253151 . This is a "HEALTH ADVANTAGE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 253151 . This is a "MCLAREN HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1962541318 . This is a "MCLAREN GROUP NPI #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 680B512650 . This is a "BCBSM-BCN-FEP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".