Blue Water Anesthesia Consultants, PC
Anesthesiology in Clinton Township, MI. Organization (NPI-2).
NPI number1134437684
StatusActive
Last updated in NPPESSep 21, 2010
Details
- NPI
- 1134437684
- Entity type
- Organization (NPI-2)
- Legal business name
- Blue Water Anesthesia Consultants, PC
- Organization subpart
- No
- Enumeration date
- Sep 17, 2010
- Last updated
- Sep 21, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | – | – | Yes |
Practice location
43475 Dalcoma DrClinton Township, MI 48038-3591
Phone 586-263-5073
Mailing address
255 W Michigan AveJackson, MI 49201-2218
Phone 517-787-6440 · Fax 517-787-4146
Authorized official
John V Morreale
Authorized Representative
3134170226
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