Provider Demographics
NPI:1245634310
Name:GUARDIAN ANESTHESIA SERVICES PLLC
Entity type:Organization
Organization Name:GUARDIAN ANESTHESIA SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-400-3169
Mailing Address - Street 1:39482 DORCHESTER CIR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-5000
Mailing Address - Country:US
Mailing Address - Phone:989-400-3169
Mailing Address - Fax:
Practice Address - Street 1:2333 PROGRESS ST
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9384
Practice Address - Country:US
Practice Address - Phone:989-345-3660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty