Organization
LONG LAKE ANESTHESIOLOGY CONSULTANTS, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD SIWEK M.D. (VICE PRESIDENT)
(248) 835-9829
Entity
Organization
Contact information
Practice address
4550 INVESTMENT DR, SUITE 100, TROY, MI 48098-6363
(800) 581-9044
(248) 856-3357
Mailing address
4550 INVESTMENT DR, SUITE 100, TROY, MI 48098-6363
(800) 581-9044
(248) 856-3357
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050F301710
BCBSM
MI
Enumeration date
10/06/2006
Last updated
04/12/2023
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