Healthcare Provider Details

I. General information

NPI: 1053290676
Provider Name (Legal Business Name): AMERICAN SURGICAL PROFESSIONAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 AVIS DR STE 200
ANN ARBOR MI
48108-9517
US

IV. Provider business mailing address

359 ENTERPRISE CT STE C
BLOOMFIELD TOWNSHIP MI
48302-1055
US

V. Phone/Fax

Practice location:
  • Phone: 833-276-2677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: BILJANA TRUJILLO
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 833-276-2677