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SOUTH EASTERN MICHIGAN COLON & RECTAL SURGERY NPI 1497119689


NPI Information

NPI: 1497119689
Provider Name: SOUTH EASTERN MICHIGAN COLON & RECTAL SURGERY
Classification: Colon & Rectal Surgery - 208C00000X
Entity Type: Organization
Address:
3106 S WAYNE RD
WAYNE, MI
ZIP 48184
Phone: (734) 722-1063
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SOUTH EASTERN MICHIGAN COLON & RECTAL SURGERY is a colon rectal surgery in Wayne, MI. The provider is a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. SOUTH EASTERN MICHIGAN COLON & RECTAL SURGERY NPI is 1497119689. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3106 S WAYNE RD
WAYNE, MI
ZIP 48184-221
Phone: (734) 722-1063
Fax: (734) 722-4815

The provider's authorized official is Adewunmi Adeyemo .
The authorized official title is Owner and has the following contact phone number (743) 722-6300.

The enumeration date for this NPI number is 4/13/2016 and was last updated on 11/17/2020.


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
1208C00000XColon & Rectal SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11497119689MEDICAIDMICHIGAN

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

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