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Organization

GREAT LAKES SURGERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID N. BROWN M.D. (MANAGER MEMBER)
(269) 428-3300
Entity
Organization

Contact information

Practice address
2848 NILES RD, SUITE B, SAINT JOSEPH, MI 49085-3352
(269) 428-3304
Mailing address
2848 NILES RD, SUITE B, SAINT JOSEPH, MI 49085-3352
(269) 428-3304

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
261QS0132X
Ophthalmologic Surgery Clinic/Center

Other

Enumeration date
01/20/2016
Last updated
11/12/2021
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