Organization
WOODLAND AMBULATORY SURGERY
Active
Other names
Trinity Health-Michigan
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARRY C FAJA (PRESIDENT AND CEO)
(734) 712-3791
Entity
Organization
Contact information
Practice address
7575 GRAND RIVER RD, BRIGHTON, MI 48114-9309
(810) 844-7588
Mailing address
7575 GRAND RIVER RD, BRIGHTON, MI 48114-9309
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40210
BLUE CROSS PROVIDER NUM
MI
Enumeration date
04/06/2007
Last updated
08/22/2020
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