Organization
GREAT LAKES ANESTHESIA
Active
Organization
GREAT LAKES ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN PAUL CLINGERMAN CRNA (PRESIDENT)
(734) 241-3891
Entity
Organization
Contact information
Practice address
400 MEDICAL PARK DR, WATERVLIET, MI 49098-9225
(734) 241-3891
(734) 241-0014
Mailing address
5623 E DUNBAR RD, MONROE, MI 48161-9127
(734) 241-3891
(734) 241-0014
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704189375
MI
Other
Enumeration date
09/14/2006
Last updated
08/20/2013
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