Provider Demographics
NPI:1902390958
Name:FLINT EMERGENT SURGICAL SERVICES
Entity Type:Organization
Organization Name:FLINT EMERGENT SURGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:NADIR
Authorized Official - Middle Name:
Authorized Official - Last Name:IJAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-275-9371
Mailing Address - Street 1:4800 S SAGINAW ST STE 1800
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2677
Mailing Address - Country:US
Mailing Address - Phone:102-759-3718
Mailing Address - Fax:
Practice Address - Street 1:1020 CHARTER DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3584
Practice Address - Country:US
Practice Address - Phone:810-720-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty