| Southeast Michigan Surgical Hospital, Llc | |
|
21230 Dequindre Rd Warren MI 48091-2279 | |
| (586) 427-1000 | |
| (586) 759-0237 |
| Full Name | Southeast Michigan Surgical Hospital, Llc |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 21230 Dequindre Rd, Warren, Michigan |
| Authorized Official Name and Position | Nadir Ijaz (DIRECTOR) |
| Authorized Official Contact | 8102759371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Michigan Surgical Hospital, Llc 21230 Dequindre Rd Warren MI 48091-2279 Ph: (586) 427-1000 | Southeast Michigan Surgical Hospital, Llc 21230 Dequindre Rd Warren MI 48091-2279 Ph: (586) 427-1000 |
| NPI Number | 1962402354 |
|---|---|
| Provider Enumeration Date | 07/28/2005 |
| Last Update Date | 05/01/2025 |
| Certification Date | 05/01/2025 |
| Medicare PECOS PAC ID | 2860303278 |
|---|---|
| Medicare Enrollment ID | O20030828000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962402354 | NPI | - | NPPES |
| 00297 | Other | MI | BCBS PROVIDER ID # |
| 404554179 | Medicaid | MI | |
| 00947 | Other | MI | CAPE MEDICAL PROV ID# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Secondary |
| 282N00000X | General Acute Care Hospital | 500100 (Michigan) | Primary |
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