Organization
HURON SURGICAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALID DEMASHKIEH M.D. (PRESIDENT)
(810) 987-3556
Entity
Organization
Contact information
Practice address
1522 PINE GROVE AVE, SUITE C, PORT HURON, MI 48060-3382
(810) 987-3556
(810) 987-5090
Mailing address
1522 PINE GROVE AVE, SUITE C, PORT HURON, MI 48060-3382
(810) 987-3556
(810) 987-5090
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020G463000
BCBS
MI
Enumeration date
11/20/2006
Last updated
12/01/2009
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