Provider Demographics
NPI:1811562184
Name:MICHIGAN ORTHOPAEDIC SURGEONS PLLC
Entity Type:Organization
Organization Name:MICHIGAN ORTHOPAEDIC SURGEONS PLLC
Other - Org Name:MICHIGAN ORTHOPAEDIC SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:TUJAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-714-1625
Mailing Address - Street 1:26211 CENTRAL PARK BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4157
Mailing Address - Country:US
Mailing Address - Phone:248-714-1635
Mailing Address - Fax:248-327-6144
Practice Address - Street 1:4967 CROOKS RD STE 100
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-5812
Practice Address - Country:US
Practice Address - Phone:248-509-9700
Practice Address - Fax:248-509-9701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHIGAN ORTHOPAEDIC SURGEONS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-20
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty