MEDICARE: ASCENSION MEDICAL GROUP MICHIGAN

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
1	208600000X	Surgery Physician	51011604	MI

General Provider Information

NPI Number	:	1548433626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCENSION MEDICAL GROUP MICHIGAN

Provider Business Mailing Address
First Line	:	PO BOX 14129
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4032
Country	:	US
Telephone Number	:	248-680-8000
Fax Number	:	248-292-3852

Provider Business Practice Location Address
First Line	:	4014 RIVER RD
Second Line	:	3B
City	:	EAST CHINA
State	:	MI
Zip	:	48054-2916
Country	:	US
Telephone Number	:	810-329-4779
Fax Number	:	810-329-7860

Authorized Official
Title or Position	:	MANAGER
Name	:	RACHEL R PERRY
Credential	:
Telephone Number	:	248-221-1918

Provider Enumeration Date	:	04/09/2008
Last Update Date	:	04/16/2025

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Directions to “ASCENSION MEDICAL GROUP MICHIGAN ” Practice Location

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