Organization
TROY GASTROENTEROLOGY, PC
Active
Parent organization
TROY GASTROENTEROLOGY, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TROY GASTROENTEROLOGY, PC
Authorized official
SANTE D BOLOGNA MD (SENIOR PARTNER)
(248) 844-9710
Entity
Organization
Contact information
Practice address
4600 INVESTMENT DR, SUITE 270, TROY, MI 48098-6365
(248) 844-9710
Mailing address
50438 VAN DYKE AVE, #B, SHELBY TOWNSHIP, MI 48317-1358
(586) 726-8423
(586) 726-8557
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF4836
MEDICARE RAILROAD
MI
Enumeration date
05/17/2006
Last updated
09/28/2007
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