1952775975 NPI number — INSIGHT ANESTHESIA PLLC

Table of content: (NPI 1952775975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952775975 NPI number — INSIGHT ANESTHESIA PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSIGHT ANESTHESIA PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952775975
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4800 S SAGINAW ST
Provider Second Line Business Mailing Address:
SUITE 1840
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48507-2677
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-732-8336
Provider Business Mailing Address Fax Number:
810-239-4346

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4800 S SAGINAW ST
Provider Second Line Business Practice Location Address:
SUITE 1840
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48507-2677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-732-8336
Provider Business Practice Location Address Fax Number:
810-239-4346
Provider Enumeration Date:
11/16/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BAWAHAB
Authorized Official First Name:
ATIF
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMIN
Authorized Official Telephone Number:
979-574-7109

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)