Organization · NPI-2

Advanced Laparoscopic Surgery, P.C.

Surgery · Troy, MI

NPI number1265714190
StatusActive
Last updated in NPPESJun 17, 2020

Details

NPI
1265714190
Entity type
Organization (NPI-2)
Legal business name
Advanced Laparoscopic Surgery, P.C.
Organization subpart
No
Enumeration date
Sep 16, 2011
Certification date
Jun 17, 2020
Last updated
Jun 17, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery4301058821MIYes

Practice location

1380 Coolidge Hwy Ste 200
Troy, MI 48084-7068

Phone 248-291-6516 · Fax 248-291-6518

Mailing address

1380 Coolidge Hwy Ste 200
Troy, MI 48084-7068

Phone 248-291-6516 · Fax 248-291-6518

Authorized official

David Chengelis
Owner
2482916516

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