Organization
GREAT LAKES SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH METZ MD (MEDICAL DIRECTOR)
(248) 223-9925
Entity
Organization
Contact information
Practice address
26051 LAHSER RD, SOUTHFIELD, MI 48033-2601
(248) 223-9925
Mailing address
26051 LAHSER RD, SOUTHFIELD, MI 48033-2601
(248) 223-9925
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1010000049
MI
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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