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General NPI Number Information
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NPI Number | 1245708403
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Entity Type | Organization
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Legal Business Name | AMERICAN ANESTHESIOLOGY GROUP OF MICHIGAN, P.C.
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 1848 E SHERMAN BLVD STE Y
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City | MUSKEGON
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State | MI
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Zip | 49444-1963
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Country | US
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Telephone | 231-726-4498
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 WALT WHITMAN RD STE 300
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City | MELVILLE
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State | NY
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Zip | 11747-4300
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Country | US
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Telephone | 516-945-3000
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. MATTHEW WALSH
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Credential | MD
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Telephone | 800-243-3839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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