# THORACIC SURGICAL SERVICES, PC

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

## Provider details

- **NPI number:** 1841840113
- **Authorized official:** PATRICIA WALL (BILLER)
- **Authorized official phone:** (248) 296-0118

## Contact information

- **Practice address:** 4100 JOHN R ST, DETROIT, MI 48201-2013
- **Practice address phone:** (248) 676-2582
- **Mailing address:** 2186 CRANE ST, WATERFORD, MI 48329-3721
- **Mailing address phone:** (248) 296-0118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2019
- **Last updated:** 12/16/2019