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Organization
SURMOUNTING LLC
Active
Organization
SURMOUNTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INGRID LEWIS (AUTHORIZED OFFICIAL)
(313) 930-0258
Entity
Organization
Contact information
Practice address
12866 FORT ST, SOUTHGATE, MI 48195-1060
(734) 720-7920
Mailing address
20831 RIDGEMONT RD, HARPER WOODS, MI 48225-1137
(313) 930-0258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
06/29/2024
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