Organization
ANESTHESIA SERVICES, PC GRACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIR FULEIHAN (AUTHORIZED REPRESENTATIVE)
(313) 966-3300
Entity
Organization
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-3300
Mailing address
P O BOX 1123, 255 W MICHIGAN AVE, JACKSON, MI 49204-1123
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/10/2006
Last updated
08/15/2011
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