# PIONEER ENDOSCOPY & SURGERY CENTER, L.L.C.

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

## Provider details

- **NPI number:** 1649752650
- **Authorized official:** DR. GHAITH M IBRAHIM MD (BOARD EXECUTIVE)
- **Authorized official phone:** (586) 215-7476

## Contact information

- **Practice address:** 36401 VAN DYKE AVE, STERLING HEIGHTS, MI 48312-2763
- **Practice address phone:** (586) 757-6400
- **Practice address fax:** (586) 757-8400
- **Mailing address:** PO BOX 370, STERLING HEIGHTS, MI 48311-0370
- **Mailing address phone:** (586) 771-0270
- **Mailing address fax:** (586) 343-8870

## Taxonomy

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

## Other

- **Enumeration date:** 09/06/2018
- **Last updated:** 05/30/2023