Provider Demographics
NPI:1457886996
Name:MUSKEGON SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:MUSKEGON SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:POPPEMA
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:231-739-1916
Mailing Address - Street 1:DEPT 2033
Mailing Address - Street 2:PO BOX 30516
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-8016
Mailing Address - Country:US
Mailing Address - Phone:231-830-3982
Mailing Address - Fax:231-830-3998
Practice Address - Street 1:1675 PATRIOT DR
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-7807
Practice Address - Country:US
Practice Address - Phone:231-739-1933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MUSKEGON SURGICAL ASSOCIATES, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-21
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty