Provider Demographics
NPI:1770603706
Name:BIRMINGHAM AMBULATORY SURGICAL CENTER, PLLC
Entity type:Organization
Organization Name:BIRMINGHAM AMBULATORY SURGICAL CENTER, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:F
Authorized Official - Last Name:HANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-649-1644
Mailing Address - Street 1:230 W MAPLE ROAD
Mailing Address - Street 2:STE 100
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-5435
Mailing Address - Country:US
Mailing Address - Phone:248-244-1500
Mailing Address - Fax:248-250-7230
Practice Address - Street 1:230 W MAPLE ROAD
Practice Address - Street 2:STE 100
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-5435
Practice Address - Country:US
Practice Address - Phone:248-244-1500
Practice Address - Fax:248-250-7230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-31
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
MI1010000076261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical