Provider Demographics
NPI:1851439012
Name:ALPENA SURGICAL ASSOCIATES, P.L.L.C.
Entity Type:Organization
Organization Name:ALPENA SURGICAL ASSOCIATES, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GROHOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-354-5717
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-0535
Mailing Address - Country:US
Mailing Address - Phone:989-354-5717
Mailing Address - Fax:989-356-6526
Practice Address - Street 1:311 LONG RAPIDS PLZ
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1375
Practice Address - Country:US
Practice Address - Phone:989-354-5717
Practice Address - Fax:989-356-6526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICH1975OtherRR MEDICARE
MICH1975OtherRR MEDICARE