Organization
GREAT LAKES EYE SURGERY LLC
Active
Other names
GREAT LAKES EYE ANESTHESIA
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAD K SHOKOOHI M.D. (OWNER)
(989) 793-2820
Entity
Organization
Contact information
Practice address
2393 SCHUST RD, SAGINAW, MI 48603-1334
(734) 241-3891
(734) 241-0014
Mailing address
5623 E DUNBAR RD, MONROE, MI 48161-9127
(734) 241-3891
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/20/2023
Last updated
04/20/2023
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