Healthcare Provider Details

I. General information

NPI: 1447206719
Provider Name (Legal Business Name): MONROE COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 STEWART RD
MONROE MI
48162-4291
US

IV. Provider business mailing address

750 STEWART RD
MONROE MI
48162-4291
US

V. Phone/Fax

Practice location:
  • Phone: 734-240-1900
  • Fax: 734-240-1901
Mailing address:
  • Phone: 734-240-1900
  • Fax: 734-240-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL WAKEMAN
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 734-240-1900