# GREAT LAKES SURGICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265856231
- **Authorized official:** KEITH METZ MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (248) 223-9925

## Contact information

- **Practice address:** 26051 LAHSER RD, SOUTHFIELD, MI 48033-2601
- **Practice address phone:** (248) 223-9925
- **Mailing address:** 26051 LAHSER RD, SOUTHFIELD, MI 48033-2601
- **Mailing address phone:** (248) 223-9925

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 1010000049 | MI | Yes |

## Other

- **Enumeration date:** 02/12/2014
- **Last updated:** 02/12/2014