Evanston Surgical Center Llc

NPI 1003081522 - Surgery - 208600000X

NPI Details
NPI 1003081522
Enumeration Date 04/25/2008
Last Updated 10/20/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name MICHAEL J MICHAEL
Position OWNER/MD
Phone (307) 789-1390
Fax (307) 789-1391
Practice Location
196 ARROWHEAD DR
SUITE 8
EVANSTON WY, 82930-8752, US
Phone (307) 789-1390
Fax (307) 789-1391
Business Location
196 ARROWHEAD DR
SUITE 8
EVANSTON WY, 82930-8752, US
Phone (435) 613-9500
Fax (435) 613-9414
Toxanomy
Taxonomy Code 208600000X
License State Wyoming
License Number 5079A
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According to our database, Evanston Surgical Center Llc NPI is 1003081522, taxonomy code is 208600000X and license number is 5079A, license state is located at Wyoming. Evanston Surgical Center Llc physically located at 196 Arrowhead Dr, Evanston WY, 82930-8752. NPI Number 1033115704 has the healthcare provider type.

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1003081522 NPI number is provided on an as is basis without warranty of any kind. 1003081522 is maintained by the National Plan & Provider Enumeration System. The contents of Evanston Surgical Center Llc are for informational purposes only.