Basic Information
| Provider Information | |||||||||
| NPI: | 1457886996 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MUSKEGON SURGICAL ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1316 MERCY DR | ||||||||
| Address2: | |||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494441835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317391930 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1675 PATRIOT DR | ||||||||
| Address2: | |||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494447807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317391933 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2017 | ||||||||
| LastUpdateDate: | 04/21/2017 | ||||||||
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| AuthorizedOfficialLastName: | CURRAN | ||||||||
| AuthorizedOfficialFirstName: | CINDY | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2317391930 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MUSKEGON SURGICAL ASSOCIATES, PLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.