Provider Demographics
NPI:1992459663
Name:MICHIGAN OUTPATIENT SURGERY CENTER INC
Entity type:Organization
Organization Name:MICHIGAN OUTPATIENT SURGERY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:586-296-7250
Mailing Address - Street 1:33080 UTICA RD
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-2038
Mailing Address - Country:US
Mailing Address - Phone:586-218-5890
Mailing Address - Fax:
Practice Address - Street 1:33080 UTICA RD STE A
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-2038
Practice Address - Country:US
Practice Address - Phone:586-296-7250
Practice Address - Fax:586-218-5894
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHIGAN OUTPATIENT SURGERY CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-10
Last Update Date:2023-10-20
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