Provider Demographics
NPI:1427197490
Name:SURGICAL ASSOCIATES, PLC
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:G
Authorized Official - Last Name:GUTEKUNST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-694-9700
Mailing Address - Street 1:8235 HOLLY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2441
Mailing Address - Country:US
Mailing Address - Phone:810-694-9700
Mailing Address - Fax:810-694-9940
Practice Address - Street 1:8235 HOLLY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2441
Practice Address - Country:US
Practice Address - Phone:810-694-9700
Practice Address - Fax:810-694-9940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI020B511640OtherBLUE CARE NETWORK
MI0N89830OtherBLUE CROSS MEDICARE ADVAN
MI1015760OtherMCLAREN HEALTH PLAN
MIC20472OtherRAILROAD MEDICARE
MI105248OtherPREFERRED CHOICE
MIC20472OtherPALMETTO GBA - RR MEDICAR
MI1015760OtherMCLAREN HEALTH PLAN
MIC20472OtherRAILROAD MEDICARE
MI105248OtherPREFERRED CHOICE