Provider Demographics
NPI:1447366224
Name:WEST MICHIGAN SURGERY CENTER, LLC
Entity type:Organization
Organization Name:WEST MICHIGAN SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GIRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNEJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-592-1360
Mailing Address - Street 1:20095 GILBERT RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-2339
Mailing Address - Country:US
Mailing Address - Phone:231-592-3102
Mailing Address - Fax:231-592-3402
Practice Address - Street 1:20095 GILBERT RD
Practice Address - Street 2:SUITE A
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2339
Practice Address - Country:US
Practice Address - Phone:231-592-3102
Practice Address - Fax:231-592-3402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23C0001081Medicare Oscar/Certification