Organization
CADILLAC SURGICAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM ANDERSON OFFICE MANAGER (OFFICE MANAGER)
(231) 876-3876
Entity
Organization
Contact information
Practice address
927 CARMEL ST, CADILLAC, MI 49601-2547
(231) 876-3876
(231) 775-1115
Mailing address
927 CARMEL ST, CADILLAC, MI 49601-2547
(231) 876-3876
(231) 775-1115
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6214400001
MEDICARE INDENTIFICATION NUMBER
MI
Enumeration date
07/10/2006
Last updated
07/27/2010
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