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NPI Code Detail

MEDICARE: SURGICAL ASSOCIATES OF MIDMICHIGAN PC

MEDICARE: SURGICAL ASSOCIATES OF MIDMICHIGAN PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist4301059228MI

General Provider Information

NPI Number : 1376618595
Entity Type Code : Organization
Provider Name (Legal Business Name) : SURGICAL ASSOCIATES OF MIDMICHIGAN PC
Provider Business Mailing Address
First Line : 4007 ORCHARD DR
Second Line : SUITE 2003
City : MIDLAND
State : MI
Zip : 48640-6113
Country : US
Telephone Number : 989-631-6710
Fax Number : 989-631-8583
Provider Business Practice Location Address
First Line : 4007 ORCHARD DR
Second Line : SUITE 2003
City : MIDLAND
State : MI
Zip : 48640-6113
Country : US
Telephone Number : 989-631-6710
Fax Number : 989-631-8583
Authorized Official
Title or Position : PRESICENT
Name : JAMES R SHEPICH
Credential : M.D.
Telephone Number : 989-631-6710
Provider Enumeration Date : 11/22/2006
Last Update Date : 08/22/2020

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Directions to “SURGICAL ASSOCIATES OF MIDMICHIGAN PC ” Practice Location

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