Organization
AEGIS ANESTHESIA, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY JE HOUGHTON D.O. (OWNER)
(734) 479-0748
Entity
Organization
Contact information
Practice address
23901 LAHSER RD, SOUTHFIELD, MI 48033-6035
(248) 357-3360
Mailing address
13829 HAMILTON ST, RIVERVIEW, MI 48193-7841
(734) 479-0748
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5101010411
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050F355980
BCBSMI PIN
MI
Enumeration date
02/07/2008
Last updated
06/13/2008
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