Provider Demographics
NPI:1598911943
Name:MICHIGAN CRH SURGEONS, PC
Entity Type:Organization
Organization Name:MICHIGAN CRH SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF CONTRACTING
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:STANDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:425-284-7890
Mailing Address - Street 1:4040 LAKE WASHINGTON BLVD NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7874
Mailing Address - Country:US
Mailing Address - Phone:425-284-7890
Mailing Address - Fax:425-284-7896
Practice Address - Street 1:6815 DIXIE HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2092
Practice Address - Country:US
Practice Address - Phone:425-284-7890
Practice Address - Fax:425-284-7896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty