Healthcare Provider Details

I. General information

NPI: 1952342453
Provider Name (Legal Business Name): SAGINAW VALLEY ENDOSCOPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 FASHION SQUARE BLVD
SAGINAW MI
48603-1247
US

IV. Provider business mailing address

PO BOX 1702
MIDLAND MI
48641-1702
US

V. Phone/Fax

Practice location:
  • Phone: 989-791-4580
  • Fax:
Mailing address:
  • Phone: 989-839-6636
  • Fax: 989-839-0021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILIP A. DEAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 989-497-9667