Provider Demographics
NPI:1790877272
Name:PONTIAC ANESTHESIA CARE ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:PONTIAC ANESTHESIA CARE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:URBANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-935-8900
Mailing Address - Street 1:PO BOX 210309
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48321-0309
Mailing Address - Country:US
Mailing Address - Phone:248-935-8900
Mailing Address - Fax:
Practice Address - Street 1:50 N. PERRY STREET
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342
Practice Address - Country:US
Practice Address - Phone:248-338-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0998711OtherHEALTH PLUS OF MICHIGAN
MINC007673OtherMCARE
MINC007673OtherMCARE
MI0N65550Medicare ID - Type Unspecified