MICHIGAN SURGERY SPECIALISTS P.C. NPI 1164411278

NPI Information

  • NPI: 1164411278
  • Provider Name: MICHIGAN SURGERY SPECIALISTS P.C.
  • Classification: Clinic/Center - 261QX0100X
  • Specialization: Occupational Medicine
  • Entity Type: Organization
  • :
  • CLIA Number: 23D2262628
  • Address: 11012 E 13 MILE RD STE 200
    WARREN, MI
    ZIP 48093
  • Phone: (586) 573-8890

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NPI Details

MICHIGAN SURGERY SPECIALISTS P.C. is an occupational medicine clinic center in Warren, MI. MICHIGAN SURGERY SPECIALISTS P.C. NPI is 1164411278. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

11012 E 13 MILE RD STE 200
WARREN, MI
ZIP 48093
Phone: (586) 573-8890
Fax: (586) 573-2706

The provider's authorized official is Michele L Kudlor .
The authorized official title is Billing Manager and has the following contact phone number (586) 558-9705.

The CLIA number assigned to this NPI record is 23D2262628 - independent with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/20/2005 and was last updated on 10/30/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic SupplierNo
2261QP2000XClinic/CenterPhysical TherapyNo
3208100000XPhysical Medicine & RehabilitationNo
4261QX0100XClinic/CenterOccupational MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1236575OTHERMICHIGANMEDICARE
21164411278MEDICAIDMICHIGAN
330697OTHERMICHIGANBLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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