MEDICARE: SURGICAL ASSOCIATES, PLC

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	208600000X	Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0N89830	OTHER	MI	BLUE CROSS MEDICARE ADVAN
4	C20472	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020B511640	OTHER	MI	BLUE CARE NETWORK
3	1015760	OTHER	MI	MCLAREN HEALTH PLAN
5	105248	OTHER	MI	PREFERRED CHOICE
6	C20472	OTHER	MI	PALMETTO GBA - RR MEDICAR

General Provider Information

NPI Number	:	1427197490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL ASSOCIATES, PLC

Provider Business Mailing Address
First Line	:	8235 HOLLY RD
Second Line	:	SUITE 1
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-2441
Country	:	US
Telephone Number	:	810-694-9700
Fax Number	:	810-694-9940

Provider Business Practice Location Address
First Line	:	8235 HOLLY RD
Second Line	:	SUITE 1
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-2441
Country	:	US
Telephone Number	:	810-694-9700
Fax Number	:	810-694-9940

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CARL G GUTEKUNST
Credential	:	D.O.
Telephone Number	:	810-694-9700

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	04/29/2009

Similar Medicare Providers

1497795462 — DR. DIANNE E GREGORY M.D.
Practice Location Address:

8235 HOLLY RD , SUITE 1
GRAND BLANC, MI
48439-2441

Practice Phone: 810-694-9110
Practice Fax: 810-695-0343

1821013855 — CARL G GUTEKUNST D.O.
Practice Location Address:

8235 HOLLY RD , SUITE 1
GRAND BLANC, MI
48439-2441

Practice Phone: 810-694-9700
Practice Fax: 810-694-9940

1295751550 — CHRISTOPHER J ASH D.O.
Practice Location Address:

8235 N HOLLY RD , SUITE 1
GRAND BLANC, MI
48439-2441

Practice Phone: 810-694-9700
Practice Fax: 810-694-9940

1427074772 — JOHN E VANCE D.O.
Practice Location Address:

8235 N HOLLY RD , SUITE 1
GRAND BLANC, MI
48439-2441

Practice Phone: 810-694-9700
Practice Fax: 810-694-9940

1912052010 — CHILD AND ADULT MEDICINE OF GRAND BLANC
Practice Location Address:

8235 HOLLY RD , SUITE 1
GRAND BLANC, MI
48439-2441

Practice Phone: 810-694-9110
Practice Fax:

1104956895 — ANDREA JO GOETHALS D.O.
Practice Location Address:

8235 HOLLY RD , SUITE 1
GRAND BLANC, MI
48439-2441

Practice Phone: 810-694-9700
Practice Fax: 810-694-9940

Directions to “SURGICAL ASSOCIATES, PLC ” Practice Location

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