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SOUTHEAST MICHIGAN SURGICAL HOSPITAL LLC NPI 1679605570


NPI Information

NPI: 1679605570
Provider Name: SOUTHEAST MICHIGAN SURGICAL HOSPITAL, LLC

Doing Business As: SOUTHEAST MICHIGAN SURGICAL HOSPITAL

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
21230 DEQUINDRE RD
WARREN, MI
ZIP 48091
Phone: (586) 427-1000
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SOUTHEAST MICHIGAN SURGICAL HOSPITAL, LLC is a specialist in Warren, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHEAST MICHIGAN SURGICAL HOSPITAL, LLC NPI is 1679605570. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southeast Michigan Surgical Hospital.

The provider's business location address is:

21230 DEQUINDRE RD
WARREN, MI
ZIP 48091-279
Phone: (586) 427-1000
Fax: (586) 759-0237

The provider's authorized official is Nadir Ijaz .
The authorized official title is Director and has the following contact phone number (810) 275-9371.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 11/25/2019.


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
1174400000XSpecialistYes

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
10E01458OTHERMICHIGANBCBS PROVIDER ID#
22619390MEDICAIDMICHIGAN
30E01458OTHERMICHIGANBCBS MEDICAL DOCTORS

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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