Organization
INNOVATIVE ANESTHESIA SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL JUGAN M.D. (OWNER)
(616) 780-7489
Entity
Organization
Contact information
Practice address
847 PARCHMENT DR SE STE 105, GRAND RAPIDS, MI 49546
(616) 516-4837
Mailing address
847 PARCHMENT DR SE STE 105, GRAND RAPIDS, MI 49546-2377
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
4301091286
MI
Other
Enumeration date
10/14/2014
Last updated
09/05/2018
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