Organization
SURGEONS OF MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN BOLTON MD (PRESIDENT)
(248) 335-9449
Entity
Organization
Contact information
Practice address
44555 WOODWARD AVE, SUITE 201, PONTIAC, MI 48341-5031
(248) 335-9449
(248) 858-3933
Mailing address
44555 WOODWARD AVE, SUITE 201, PONTIAC, MI 48341-5031
(248) 335-9449
(248) 858-3933
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301038308
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0206308521
BLUE CROSS BLUE SHIELD
MI
Enumeration date
09/28/2006
Last updated
02/11/2008
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