Provider Demographics
NPI:1215112750
Name:BEECHER SURGICAL ASSOCIATES, PLLC
Entity type:Organization
Organization Name:BEECHER SURGICAL ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZOUHEIR
Authorized Official - Middle Name:
Authorized Official - Last Name:FARES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-733-8400
Mailing Address - Street 1:8384 HOLLY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1976
Mailing Address - Country:US
Mailing Address - Phone:810-733-8400
Mailing Address - Fax:810-579-7260
Practice Address - Street 1:8384 HOLLY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1976
Practice Address - Country:US
Practice Address - Phone:810-733-8400
Practice Address - Fax:810-579-7260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101008104208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0252501065OtherBLUE CROSS/BLUE SHIELD
MI111931600Medicaid
MI0P54580Medicare PIN
MIF03647Medicare UPIN