# OAKWOOD SOUTHSHORE SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oakwood Southshore Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083653935
- **Authorized official:** MR. BARRY M CULLEN (BOARD MANAGER)
- **Authorized official phone:** (313) 982-3010

## Contact information

- **Practice address:** 5452 FORT ST, SUITE 100, TRENTON, MI 48183-4601
- **Practice address phone:** (734) 479-7070
- **Practice address fax:** (734) 479-7074
- **Mailing address:** 5452 FORT ST, SUITE 100, TRENTON, MI 48183-4601
- **Mailing address phone:** (734) 479-7070
- **Mailing address fax:** (734) 479-7074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 826847 | MI | Yes |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 10/20/2009