MEDICARE: ANESTHESIA SERVICES ASSOCIATES, PC ZMIP

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	174400000X	Specialist

General Provider Information

NPI Number	:	1760424022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIA SERVICES ASSOCIATES, PC ZMIP

Provider Business Mailing Address
First Line	:	744 W MICHIGAN AVE
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-1909
Country	:	US
Telephone Number	:	517-787-6440
Fax Number	:	517-787-4146

Provider Business Practice Location Address
First Line	:	2300 HAGGERTY RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2191
Country	:	US
Telephone Number	:	248-624-7246
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED REPRESENTATIVE
Name	:	DANIEL C LEE
Credential	:	M.D.
Telephone Number	:	248-624-7246

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	08/22/2020

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