MEDICARE: WEST MICHIGAN AAS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1295149227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST MICHIGAN AAS LLC

Provider Business Mailing Address
First Line	:	43422 W OAKS DR # 332
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48377-3300
Country	:	US
Telephone Number	:	248-229-4658
Fax Number	:	248-565-2495

Provider Business Practice Location Address
First Line	:	43422 W OAKS DR # 332
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48377-3300
Country	:	US
Telephone Number	:	248-229-4658
Fax Number	:	248-565-2495

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	CHRISTOPHER YOUST
Credential	:
Telephone Number	:	248-229-4658

Provider Enumeration Date	:	06/18/2014
Last Update Date	:	01/12/2016

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Directions to “WEST MICHIGAN AAS LLC ” Practice Location

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