Organization
ACADEMIC SURGICAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID E SCHEERES MD (PRESIDENT)
(616) 977-3990
Entity
Organization
Contact information
Practice address
1000 E PARIS AVE SE, SUITE 150, GRAND RAPIDS, MI 49546-3691
(616) 977-6243
(616) 977-0396
Mailing address
1000 E PARIS AVE SE, SUITE 150, GRAND RAPIDS, MI 49546-3691
(616) 977-6243
(616) 977-0396
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4736850
—
MI
05
—
4745608
—
MI
05
—
4745617
—
MI
05
—
4745635
—
MI
01
—
700D11379
BCBS GROUP NUMBER
MI
Enumeration date
05/04/2007
Last updated
08/06/2007
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