Healthcare Provider Details

I. General information

NPI: 1104978949
Provider Name (Legal Business Name): LEVEL ONE SURGICAL SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 W 13 MILE ROAD #204
ROYAL OAK MI
48073-6770
US

IV. Provider business mailing address

3535 W 13 MILE ROAD
ROYAL OAK MI
48073-6770
US

V. Phone/Fax

Practice location:
  • Phone: 248-551-9090
  • Fax: 248-551-9080
Mailing address:
  • Phone: 248-551-9090
  • Fax: 248-551-9080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS HEIDEMARIE ORLOFF
Title or Position: OFFICE MANAGER
Credential:
Phone: 248-551-9090