Provider Demographics
NPI:1346416211
Name:SITY M GIRGIS, M.D.PC
Entity type:Organization
Organization Name:SITY M GIRGIS, M.D.PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SITY
Authorized Official - Middle Name:MILAD
Authorized Official - Last Name:GIRGIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-673-5488
Mailing Address - Street 1:1184 CLEAVER RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723
Mailing Address - Country:US
Mailing Address - Phone:989-673-5488
Mailing Address - Fax:989-673-0283
Practice Address - Street 1:1184 CLEAVER RD
Practice Address - Street 2:SUITE 500
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723
Practice Address - Country:US
Practice Address - Phone:989-673-5488
Practice Address - Fax:989-673-0283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISG046987208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3407900101OtherBCBS
MI3242909Medicaid
MI3242909Medicaid
MI3242909Medicaid