Organization
EASTSIDE ASSOCIATES, LLC
Active
Organization
EASTSIDE ASSOCIATES, LLC
Active
Other names
Eastside Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT VENERI M.D. (MEDICAL DIRECTOR)
(586) 447-5112
Entity
Organization
Contact information
Practice address
28963 LITTLE MACK AVE, SUITE 103, ST CLAIR SHORES, MI 48081-3015
(586) 447-5110
(586) 774-6091
Mailing address
28963 LITTLE MACK AVE, SUITE 103, ST CLAIR SHORES, MI 48081-3015
(586) 447-5110
(586) 774-6091
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
506822
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40358
BLUE CROSS ID NUMBER
MI
Enumeration date
11/04/2005
Last updated
02/08/2017
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