EXECUTIVE AMBULATORY SURGICAL CENTER LLC NPI 1386056356

NPI Information

NPI: 1386056356
Provider Name: EXECUTIVE AMBULATORY SURGICAL CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 23D2083095

Address:
17000 EXECUTIVE PLAZA DR
SUITE 301
DEARBORN, MI
ZIP 48126
Phone: (313) 408-6613
Get Directions

EXECUTIVE AMBULATORY SURGICAL CENTER, LLC is an ambulatory surgical clinic center in Dearborn, MI. EXECUTIVE AMBULATORY SURGICAL CENTER, LLC NPI is 1386056356. The provider is registered as an organization entity type.

The provider's business location address is:

17000 EXECUTIVE PLAZA DR
SUITE 301
DEARBORN, MI
ZIP 48126-793
Phone: (313) 408-6613

The provider's authorized official is Samer Suleiman .
The authorized official title is Manager and has the following contact phone number (313) 408-6613.

The CLIA number assigned to this NPI record is 23D2083095 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/27/2014 and was last updated on 5/27/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »