Organization
MACOMB ANESTHESIA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GINNEBAUGH M.D. (PRESIDENT)
(313) 580-6383
Entity
Organization
Contact information
Practice address
15855 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3504
(800) 581-9044
Mailing address
15855 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3504
(800) 581-9044
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050E062230
BLUE CROSS BLUE SHIELD
MI
01
—
104638
CARE CHOICES
MI
01
—
135240100
USDOL
MI
01
—
AN500002
MCARE
MI
Enumeration date
11/07/2006
Last updated
01/06/2023
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