Provider Demographics
NPI:1740573211
Name:OH-MI, PLLC
Entity Type:Organization
Organization Name:OH-MI, PLLC
Other - Org Name:OH-MI ANESTHESIA, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT OF BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KORSOG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-834-9005
Mailing Address - Street 1:5972 FOX RUN
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9520
Mailing Address - Country:US
Mailing Address - Phone:734-834-9005
Mailing Address - Fax:
Practice Address - Street 1:1360 ARROWHEAD ROAD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537
Practice Address - Country:US
Practice Address - Phone:734-834-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty