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Organization
GREAT LAKES SURGERY CENTER LLC
Active
Organization
GREAT LAKES SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID N. BROWN M.D. (MANAGER MEMBER)
(269) 428-3300
Entity
Organization
Contact information
Practice address
2848 NILES RD, SUITE B, SAINT JOSEPH, MI 49085-3352
(269) 428-3304
Mailing address
2848 NILES RD, SUITE B, SAINT JOSEPH, MI 49085-3352
(269) 428-3304
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
NULL
Other
Enumeration date
01/20/2016
Last updated
11/12/2021
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