Provider Demographics
NPI:1235181223
Name:AMERICAN ANESTHESIOLOGY ASSOCIATES OF MICHIGAN, PC
Entity Type:Organization
Organization Name:AMERICAN ANESTHESIOLOGY ASSOCIATES OF MICHIGAN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-606-6499
Mailing Address - Street 1:2432 GENESYS PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8069
Mailing Address - Country:US
Mailing Address - Phone:810-606-6499
Mailing Address - Fax:810-606-7245
Practice Address - Street 1:1 GENESYS PKWY
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8065
Practice Address - Country:US
Practice Address - Phone:810-606-6499
Practice Address - Fax:810-606-7245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI430B510910OtherBCBS CRNAS
MI0024559OtherHEALTH PLUS OF MICHIGAN
MIAN380006OtherMCARE
MI050B546530OtherBCBS ANESTHESIOLOGISTS
MI5462446OtherAETNA ANESTHESIOLOGISTS
MI7910648OtherAETNA CRNAS
MIAN380006OtherMCARE
MI430B510910OtherBCBS CRNAS
MI5462446OtherAETNA ANESTHESIOLOGISTS