Organization
ASCENSION MACOMB OAKLAND HOSPITAL
Active
Organization
ASCENSION MACOMB OAKLAND HOSPITAL
Active
Other names
Michigan Neuro-Ophthalmology & Oculoplastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH STARKEL (CREDENTIALING COORDINATOR)
(248) 680-8121
Entity
Organization
Contact information
Practice address
27351 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-3487
(248) 680-8000
Mailing address
3195 SOLUTIONS CENTER BOX 773195, CHICAGO, IL 60677-0001
(248) 680-8000
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
207W00000X
Ophthalmology Physician
Primary
—
MI
208200000X
Plastic Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
FM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180E01180
BCBS GROUP NUMBER
MI
01
—
CG3113
RAILROAD MEDICARE GROUP NUMBER
MI
Enumeration date
06/19/2006
Last updated
11/15/2023
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