Organization
GREAT LAKES ANESTHESIA, PLC
Active
Organization
GREAT LAKES ANESTHESIA, PLC
Active
Other names
Anesthesia Services Associates, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMIR FULEIHAN MD (AUTHORIZED REPRESENTATIVE)
(517) 787-7438
Entity
Organization
Contact information
Practice address
1221 PINE GROVE, PORT HURON, MI 48060
(810) 989-3207
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
08/19/2008
Last updated
08/19/2008
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