NPIMap

Organization Active NPI

Surgical Specialty Group LLC

  • Surgery Physician
  • Clinton TWP, MI
National Provider Identifier
1215122437
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
AG009192 Issued in MI
Legal business name
SURGICAL SPECIALTY GROUP LLC
Practice address
16151 19 Mile Rd
Suite #301
Clinton TWP, MI 48038-1158
Phone
(586) 228-0798
Fax
(586) 228-1084
NPI assigned
Sep 11, 2007
Last updated
Sep 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Andrew Georgeson, D.O.NPI 1922017938
Title
Physician/Owner
Phone
(586) 228-0798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X AG009192 MI Primary

Addresses

Primary practice location

16151 19 Mile Rd
Suite #301
Clinton TWP, MI 48038-1158

Mailing address

16151 19 Mile Rd
Suite #301
Clinton TWP, MI 48038-1158
Phone (586) 228-0798

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1215122437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16151 19 MILE RD",
            "address_2": "SUITE #301",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381158",
            "telephone_number": "586-228-0798",
            "fax_number": "586-228-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16151 19 MILE RD",
            "address_2": "SUITE #301",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381158",
            "telephone_number": "586-228-0798",
            "fax_number": "586-228-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALTY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "GEORGESON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "586-228-0798",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "AG009192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.