MACOMB SURGICAL ASSOCIATESP.C. NPI 1295816932

NPI Information

NPI: 1295816932
Provider Name: MACOMB SURGICAL ASSOCIATES,P.C.
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
37400 GARFIELD RD
SUITE 120
CLINTON TWP, MI
ZIP 48036
Phone: (586) 228-3800
Get Directions

MACOMB SURGICAL ASSOCIATES,P.C. is a vascular surgery surgery in Clinton Twp, MI. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. MACOMB SURGICAL ASSOCIATES,P.C. NPI is 1295816932. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

37400 GARFIELD RD
SUITE 120
CLINTON TWP, MI
ZIP 48036-648
Phone: (586) 228-3800
Fax: (586) 228-9800

The provider's authorized official is James Edward Johnson .
The authorized official title is President and has the following contact phone number (586) 228-3800.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 1/20/2010.

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	208600000X	Surgery		013279	MICHIGAN	No
2	2086S0129X	Surgery	Vascular Surgery	008771	MICHIGAN	No
3	2086S0129X	Surgery	Vascular Surgery	007081	MICHIGAN	Yes

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
1	E41641	MEDICARE UPIN	MICHIGAN
2	0P28900	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN	GROUP ID NUMBER
3	3464424	MEDICAID	MICHIGAN
4	4837559	MEDICAID	MICHIGAN
5	4401008	MEDICAID	MICHIGAN
6	2125953	MEDICAID	MICHIGAN
7	G71693	MEDICARE UPIN	MICHIGAN
8	E26084	MEDICARE UPIN	MICHIGAN
9	H61334	MEDICARE UPIN	MICHIGAN

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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