Organization
PHYSICIAN ANESTHESIA SERVICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK COOK MD (AUTHORIZED OFFICIAL)
(800) 891-2351
Entity
Organization
Contact information
Practice address
826 W KING ST, OWOSSO, MI 48867-2120
(989) 723-5211
Mailing address
DEPT 78178 PO BOX 78000, DETROIT, MI 48278-0178
(800) 891-2351
(800) 891-2351
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
09/20/2005
Last updated
08/19/2020
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