Organization
GREAT LAKES ANESTHESIA CONSULTANTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIJ M. DEWAN MD (MEMBER)
(269) 324-8406
Entity
Organization
Contact information
Practice address
7901 ANGLING RD, PORTAGE, MI 49024-0714
(269) 324-8406
Mailing address
PO BOX 19, NAZARETH, MI 49074-0019
(941) 360-1566
(941) 358-9818
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
03/27/2012
Last updated
04/30/2012
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