# MICHIGAN INSTITUTE FOR ADVANCED SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Michigan Institute for Advanced Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619077211
- **Authorized official:** CLAIRE GIBSON (SR VPO)
- **Authorized official phone:** (214) 726-6042

## Contact information

- **Practice address:** 1375 S LAPEER ROAD, SUITE 109, LAKE ORION, MI 48360
- **Practice address phone:** (248) 693-7950
- **Practice address fax:** (248) 693-2658
- **Mailing address:** 1375 S LAPEER RD STE 109, LAKE ORION, MI 48360-1421
- **Mailing address phone:** (248) 693-7950
- **Mailing address fax:** (248) 693-2658

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 1010000067 | MI | Yes |

## Other

- **Enumeration date:** 09/24/2006
- **Last updated:** 05/06/2026