Organization
SOUTHEAST MICHIGAN SURGICAL HOSPITAL, LLC
Active
Other names
SOUTHEAST MICHIGAN SURGICAL HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NADIR IJAZ (DIRECTOR)
(810) 275-9371
Entity
Organization
Contact information
Practice address
21230 DEQUINDRE RD, WARREN, MI 48091-2279
(586) 427-1000
(586) 759-0237
Mailing address
21230 DEQUINDRE RD, WARREN, MI 48091-2279
(586) 427-1000
(586) 759-0237
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E01458
BCBS MEDICAL DOCTORS
MI
05
—
2619390
—
MI
Enumeration date
03/09/2007
Last updated
11/25/2019
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