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Organization

MICHIGAN ENDOSCOPY CENTER AT PROVIDENCE PARK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRISTIN TRAHEY (ADMINISTRATOR)
(248) 465-9220
Entity
Organization

Contact information

Practice address
47601 GRAND RIVER AVE STE D-110, NOVI, MI 48374-1233
(248) 465-9220
(248) 347-1915
Mailing address
47601 GRAND RIVER AVE STE D-110, NOVI, MI 48374-1233
(248) 465-9220
(248) 347-1915

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
05/22/2013
Last updated
11/04/2025
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