# WATERFORD SURGICAL CENTER, LLC

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

## Provider details

- **NPI number:** 1467788729
- **Authorized official:** DR. BASHAR SUCCAR M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (248) 889-4580

## Contact information

- **Practice address:** 5220 HIGHLAND RD, SUITE 100, WATERFORD, MI 48327-1975
- **Practice address phone:** (248) 889-4580
- **Practice address fax:** (248) 889-4582
- **Mailing address:** 5220 HIGHLAND RD, SUITE 100, WATERFORD, MI 48327-1975
- **Mailing address phone:** (248) 889-4580
- **Mailing address fax:** (248) 889-4582

## Taxonomy

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

## Other

- **Enumeration date:** 10/21/2009
- **Last updated:** 10/21/2009