Healthcare Provider Details

I. General information

NPI: 1710340542
Provider Name (Legal Business Name): STERLING ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 S SAGINAW ST
FLINT MI
48507-2677
US

IV. Provider business mailing address

4800 S SAGINAW ST SUITE 1821
FLINT MI
48507-2677
US

V. Phone/Fax

Practice location:
  • Phone: 810-732-8336
  • Fax: 810-239-4346
Mailing address:
  • Phone: 810-732-8336
  • Fax: 888-770-6360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301098087
License Number StateMI

VIII. Authorized Official

Name: ATIF BAWAHAB
Title or Position: ADMIN
Credential:
Phone: 979-574-7109