Organization
SURGICAL SPECIALIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN GILBERT (OFFICE MANAGER)
(810) 664-4100
Entity
Organization
Contact information
Practice address
844 S MAIN ST, LAPEER, MI 48446-3027
(810) 664-4100
(810) 664-9250
Mailing address
844 S MAIN ST, LAPEER, MI 48446-3027
(810) 664-4100
(810) 664-9250
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CL4629
RAILROAD MEDICARE
MI
Enumeration date
03/05/2007
Last updated
12/06/2013
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