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General NPI Number Information
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NPI Number | 1023041852
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Entity Type | Organization
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Legal Business Name | ASCENSION MEDICAL GROUP MICHIGAN
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 11900 E 12 MILE RD SUITE 110
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City | WARREN
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State | MI
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Zip | 48093-3400
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Country | US
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Telephone | 586-582-7070
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Fax | 586-582-7066
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Provider Business Mailing Address
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Address Line | PO BOX 14129
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City | BELFAST
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State | ME
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Zip | 04915-4032
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Country | US
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Telephone | 248-680-8000
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Fax | 248-292-3852
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Authorized Official
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Title or Position | MANAGER
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Name | MS. RACHEL R PERRY
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Credential |
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Telephone | 248-221-1918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | MI
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