Provider Demographics
NPI:1497116230
Name:AUSI MEDICAL CENTER PC
Entity Type:Organization
Organization Name:AUSI MEDICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-202-2875
Mailing Address - Street 1:54251 CARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-1367
Mailing Address - Country:US
Mailing Address - Phone:248-202-2875
Mailing Address - Fax:
Practice Address - Street 1:54251 CARRINGTON DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-1367
Practice Address - Country:US
Practice Address - Phone:248-202-2875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty