Healthcare Provider Details

I. General information

NPI: 1124142781
Provider Name (Legal Business Name): MCLAREN ASC OF FLINT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SOUTH BALLENGER HIGHWAY
FLINT MI
48532-3641
US

IV. Provider business mailing address

501 SOUTH BALLENGER HIGHWAY
FLINT MI
48532-3641
US

V. Phone/Fax

Practice location:
  • Phone: 810-768-2044
  • Fax:
Mailing address:
  • Phone: 810-768-2044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE L. REED
Title or Position: OFFICER, AUTHORIZED OFFICIAL, MEDIC
Credential:
Phone: 972-763-3859