Provider Demographics
NPI:1447300843
Name:VESALIUS MEDICAL CENTER
Entity type:Organization
Organization Name:VESALIUS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:ARISTIDES
Authorized Official - Last Name:STURLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-888-0992
Mailing Address - Street 1:22635 MOORGATE ST
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-3770
Mailing Address - Country:US
Mailing Address - Phone:248-888-0992
Mailing Address - Fax:248-888-7260
Practice Address - Street 1:33750 FREEDOM RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48335-4755
Practice Address - Country:US
Practice Address - Phone:248-888-0992
Practice Address - Fax:248-888-7260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICS055462207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N98160Medicare ID - Type Unspecified