GREATER LAKES AMBULATORY SURGICAL CENTER LLC NPI 1679717466

NPI Information

  • NPI: 1679717466
  • Provider Name: GREATER LAKES AMBULATORY SURGICAL CENTER, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: GREATER LAKES AMBULATORY SURGERY CENTER
  • Address: 16100 19 MILE RD
    SUITE 100
    CLINTON TOWNSHIP, MI
    ZIP 48038
  • Phone: (586) 286-0000

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NPI Details

GREATER LAKES AMBULATORY SURGICAL CENTER, LLC is an ambulatory surgical clinic center in Clinton Township, MI. GREATER LAKES AMBULATORY SURGICAL CENTER, LLC NPI is 1679717466. The provider is registered as an organization entity type.
The provider Is Doing Business As Greater Lakes Ambulatory Surgery Center.

The provider's business location address is:

16100 19 MILE RD
SUITE 100
CLINTON TOWNSHIP, MI
ZIP 48038-148
Phone: (586) 286-0000
Fax: (586) 286-0005

The provider's authorized official is Allison Anita Brynaert .
The authorized official title is Administrator/director and has the following contact phone number (586) 286-0000.

The enumeration date for this NPI number is 4/24/2009 and was last updated on 12/28/2016.

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
1261QA1903XClinic/CenterAmbulatory Surgical506836MICHIGANYes

What is NPI?

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This page was last updated on: 3/30/2025

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