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General NPI Number Information
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NPI Number | 1184485146
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Entity Type | Organization
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Legal Business Name | MUSKEGON SURGICAL ASSOCIATES SURGICENTER, PLC
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1672 PATRIOT DRIVE
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City | MUSKEGON
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State | MI
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Zip | 49444
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Country | US
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Telephone | 231-739-9461
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Fax | 231-739-1984
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Provider Business Mailing Address
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Address Line | 1672 PATRIOT DRIVE
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City | MUSKEGON
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State | MI
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Zip | 49444
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Country | US
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Telephone | 231-739-9461
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Fax | 231-739-1984
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/PRESIDENT
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Name | RYAN P TER LOUW
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Credential | MD
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Telephone | 231-246-2445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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