# GREAT LAKES AMBULATORY SURGERY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GREAT LAKES PAIN MANAGEMENT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023498219
- **Legal business name:** GREAT LAKES PAIN MANAGEMENT
- **Authorized official:** DR. EMAD AZMY MIKHAIL M.D. (OWNER)
- **Authorized official phone:** (440) 306-2358

## Contact information

- **Practice address:** 9002 MENTOR AVE STE B, MENTOR, OH 44060-6302
- **Practice address phone:** (440) 283-0244
- **Practice address fax:** (440) 283-0247
- **Mailing address:** 9002 MENTOR AVE, MENTOR, OH 44060-6302
- **Mailing address phone:** (440) 306-2358
- **Mailing address fax:** (440) 306-2359

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 35-075570 | OH | Yes |

## Other

- **Enumeration date:** 06/03/2015
- **Last updated:** 01/13/2026