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SURGICAL SPECIALIST OF MICHIGAN PC NPI 1760603484


NPI Information

NPI: 1760603484
Provider Name: SURGICAL SPECIALIST OF MICHIGAN PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
21000 E 12 MILE RD
SUITE 112
SAINT CLAIR SHORES, MI
ZIP 48081
Phone: (586) 771-8900
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SURGICAL SPECIALIST OF MICHIGAN PC is a specialist in Saint Clair Shores, 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. SURGICAL SPECIALIST OF MICHIGAN PC NPI is 1760603484. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

21000 E 12 MILE RD
SUITE 112
SAINT CLAIR SHORES, MI
ZIP 48081-116
Phone: (586) 771-8900
Fax: (586) 771-8901

The provider's authorized official is Akash Rushikumar Sheth .
The authorized official title is President and has the following contact phone number (586) 771-8900.

The enumeration date for this NPI number is 5/1/2007 and was last updated on 11/8/2011.


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
1174400000XSpecialist4301057707MICHIGANYes

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
1G93036MEDICARE UPINMICHIGAN
2453674210MEDICAIDMICHIGAN
3453676010MEDICAIDMICHIGAN
4G24189MEDICARE UPINMICHIGAN
5N77200001MEDICARE ID-TYPE UNSPECIFIEDMICHIGANARS
6N77200002MEDICARE ID-TYPE UNSPECIFIEDMICHIGANDRS

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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