Provider Demographics
NPI:1811226244
Name:SURGICAL INSTITUTE OF MICHIGAN, LLC
Entity Type:Organization
Organization Name:SURGICAL INSTITUTE OF MICHIGAN, LLC
Other - Org Name:SURGICAL INSTITUTE OF MICHIGAN ANESTHESIA, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SCHEDULER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWITALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-729-7960
Mailing Address - Street 1:33545 CHERRY HILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-4842
Mailing Address - Country:US
Mailing Address - Phone:734-729-7960
Mailing Address - Fax:734-729-7969
Practice Address - Street 1:33545 CHERRY HILL RD
Practice Address - Street 2:STE 200
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4842
Practice Address - Country:US
Practice Address - Phone:734-729-7960
Practice Address - Fax:734-729-7969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23C0001112OtherCCN
MIMI3200Medicare PIN