Basic Information
Provider Information
NPI: 1780819979
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALYESH
FirstName: DANIEL
MiddleName: MICHAEL
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1500 E MEDICAL CENTER DR
Address2: 3RD FLOOR CARDIOVASCULAR CNETER
City: ANN ARBOR
State: MI
PostalCode: 481095856
CountryCode: US
TelephoneNumber: 7342324505
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2009
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301103262MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0001X4301103262MIY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
207RC0000X4301103262MIN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


Home