Organization
HURON GASTROENTEROLOGY ASSOCIATES PC
Active
Other names
Huron Gastro
Organization subpart
No
Provider details
NPI number
Authorized official
LANA COOPER (ADMINISTRATOR)
(734) 528-1405
Entity
Organization
Contact information
Practice address
620 BYRON RD, HOWELL, MI 48843-1002
(734) 434-6262
(734) 712-2820
Mailing address
5300 ELLIOTT DR, YPSILANTI, MI 48197-8632
(734) 434-6262
(734) 712-2820
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10H14989
BCBS GROUP
MI
01
—
CE4308
MEDICARE RAILROAD GROUP
MI
Enumeration date
06/06/2007
Last updated
08/25/2015
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