# INNOVATIVE ANESTHESIA SERVICES PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1275937625
- **Authorized official:** DR. CAROL JUGAN M.D. (OWNER)
- **Authorized official phone:** (616) 780-7489

## Contact information

- **Practice address:** 847 PARCHMENT DR SE STE 105, GRAND RAPIDS, MI 49546
- **Practice address phone:** (616) 516-4837
- **Mailing address:** 847 PARCHMENT DR SE STE 105, GRAND RAPIDS, MI 49546-2377

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 4301091286 | MI | Yes |

## Other

- **Enumeration date:** 10/14/2014
- **Last updated:** 09/05/2018