Organization
MIDLAND SURGICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLSWORTH EMIL LUDWIG MD (PRESIDENT)
(989) 631-1221
Entity
Organization
Contact information
Practice address
4007 ORCHARD DR, SUITE 2003, MIDLAND, MI 48640-6187
(989) 631-1221
(989) 631-6686
Mailing address
4007 ORCHARD DR, SUITE 2003, MIDLAND, MI 48640-6190
(989) 631-1221
(989) 631-6686
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
040961
MI
208600000X
Surgery Physician
047857
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020E66017
BCBS
MI
Enumeration date
10/11/2005
Last updated
10/01/2010
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