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NPI Code Detail

MEDICARE: PHYSICIAN ASSISTANT SERVICES

MEDICARE: PHYSICIAN ASSISTANT SERVICES
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
1282N00000XGeneral Acute Care Hospital5601002038MI

General Provider Information

NPI Number : 1679746036
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIAN ASSISTANT SERVICES
Provider Business Mailing Address
First Line : 45900 GEDDES RD
Second Line :
City : CANTON
State : MI
Zip : 48188-2306
Country : US
Telephone Number : 734-879-4100
Fax Number :
Provider Business Practice Location Address
First Line : 45900 GEDDES RD
Second Line :
City : CANTON
State : MI
Zip : 48188-2306
Country : US
Telephone Number : 734-879-4100
Fax Number :
Authorized Official
Title or Position : PHYSICIAN ASSISTANT
Name : MS. DANA LYNN EYLER
Credential : PA-C
Telephone Number : 313-966-4954
Provider Enumeration Date : 04/08/2008
Last Update Date : 07/28/2015

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Directions to “PHYSICIAN ASSISTANT SERVICES ” Practice Location

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