Organization
PSJ ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINICK LAGO MD (PRESIDENT/OWNER)
(412) 418-6077
Entity
Organization
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
(770) 237-1492
Mailing address
30400 TELEGRAPH RD, SUITE 405, BINGHAM FARMS, MI 48025-4537
(412) 418-6077
(770) 237-1492
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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