Organization
OHS-UPG VENTURES
Active
Other names
Maple Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD HETRICK (ADMINISTRATOR)
(845) 770-1883
Entity
Organization
Contact information
Practice address
1560 E. MAPLE ROAD, SUITE 100, TROY, MI 48083
(248) 817-2001
(248) 817-2020
Mailing address
1560 E. MAPLE ROAD, SUITE 100, TROY, MI 48083
(248) 817-2001
(248) 817-2020
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1030000042
MI
Other
Enumeration date
02/26/2013
Last updated
08/19/2015
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