Organization
GREAT LAKES AMBULATORY SURGERY CENTER
Active
Parent organization
GREAT LAKES PAIN MANAGEMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT LAKES PAIN MANAGEMENT
Authorized official
DR. EMAD AZMY MIKHAIL M.D. (OWNER)
(440) 306-2358
Entity
Organization
Contact information
Practice address
9002 MENTOR AVE STE B, MENTOR, OH 44060-6302
(440) 283-0244
(440) 283-0247
Mailing address
9002 MENTOR AVE, MENTOR, OH 44060-6302
(440) 306-2358
(440) 306-2359
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
35-075570
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2124534
—
OH
Enumeration date
06/03/2015
Last updated
01/13/2026
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