Provider Demographics
NPI:1952350555
Name:AMBULATORY ANESTHESIA ASSOCIATES, PC
Entity Type:Organization
Organization Name:AMBULATORY ANESTHESIA ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAUFIEK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHADI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:313-580-9501
Mailing Address - Street 1:PO BOX 1904
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-6904
Mailing Address - Country:US
Mailing Address - Phone:313-580-9501
Mailing Address - Fax:
Practice Address - Street 1:718 N MACOMB ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-7815
Practice Address - Country:US
Practice Address - Phone:734-240-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI050H226700OtherBCBS ANESTHESIOLOGISTS
MI430H227430OtherBCBS CRNAS
MIAN820030OtherMCARE
MI430H227430OtherBCBS CRNAS