Provider Demographics
NPI:1578573960
Name:SHIAWASSEE ANESTHESIA SERVICES, P.C.
Entity Type:Organization
Organization Name:SHIAWASSEE ANESTHESIA SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUWSMA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-635-7453
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:SWARTZ CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:48473-0115
Mailing Address - Country:US
Mailing Address - Phone:810-635-7453
Mailing Address - Fax:810-630-2151
Practice Address - Street 1:826 W KING ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2120
Practice Address - Country:US
Practice Address - Phone:810-635-7453
Practice Address - Fax:810-630-2151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011005207L00000X
MI4301080892207L00000X
MI5101008081207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P02920Medicare ID - Type Unspecified
MIE27036Medicare UPIN
MIH81001Medicare UPIN
MIF00559Medicare UPIN