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General NPI Number Information
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NPI Number | 1033106059
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Entity Type | Organization
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Legal Business Name | ADVANCED SLEEP CENTER
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1159 E MICHIGAN AVE STE D
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City | YPSILANTI
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State | MI
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Zip | 48198-5807
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Country | US
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Telephone | 586-773-1823
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Fax | 586-773-1211
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Provider Business Mailing Address
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Address Line | 1159 E MICHIGAN AVE STE D
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City | YPSILANTI
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State | MI
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Zip | 48198-5807
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Country | US
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Telephone | 586-773-1823
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Fax | 586-773-1211
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. GAVIN AWERBUCH
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Credential | MD
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Telephone | 586-773-1823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | GA4052276
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License Number State | MI
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