Organization
RIVERSIDE SURGICAL ASSOCIATES, PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY DONALD KAMINSKY D.O. (PRESIDENT)
(219) 902-9663
Entity
Organization
Contact information
Practice address
18025 FORT ST STE B, RIVERVIEW, MI 48193-7432
(219) 902-9663
Mailing address
18025 FORT ST, RIVERVIEW, MI 48193-7432
(734) 785-8251
(734) 785-8290
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101017755
MI
Other
Enumeration date
02/09/2015
Last updated
11/09/2015
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