Organization
TDS ANESTHESIA SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA STANTON (AUTHORIZED REPRESENTATIVE)
(800) 516-5315
Entity
Organization
Contact information
Practice address
461 W HURON ST, PONTIAC, MI 48341-1601
(517) 787-6440
Mailing address
255 W MICHIGAN AVE, PO BOX 1123, JACKSON, MI 49201-2218
(800) 242-1131
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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