Southgate Allied Anesthesia PLLC

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

4704090801 Issued in MI

Legal business name

SOUTHGATE ALLIED ANESTHESIA PLLC

Practice address

13460 Fort St
Southgate, MI 48195-1138

Phone

(313) 263-5961

Fax

(313) 263-5963

NPI assigned

Oct 24, 2015

Organization subpart

No

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

Authorized official

Name

Atif Bawahab

Title

Admin

Phone

(979) 574-7109

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1445644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445644800000",
    "number": "1689046070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2071",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481954071",
            "telephone_number": "313-263-5961",
            "fax_number": "313-263-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951138",
            "telephone_number": "313-263-5961",
            "fax_number": "313-263-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHGATE ALLIED ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-24",
        "last_updated": "2015-10-24",
        "status": "A",
        "authorized_official_last_name": "BAWAHAB",
        "authorized_official_first_name": "ATIF",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "979-574-7109"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiologist Assistant",
            "state": "MI",
            "license": "4704090801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rima Soueidan, LMSW
• Carla Soule-Pearson, PHARMD
• Sound Hearing Inc.
• Angela South
• Southfort Family Clinic PC
• Southgate Ardent PLLC
• Southgate CT, PLC
• Southgate Ear Nose & Throat Center PLLC
• Southgate Ear Nose and Throat PLLC
• Southgate Family Dental

• Anesthesiologist Assistant in Southgate, MI
• Providers in Southgate, MI by specialty
• Anesthesiologist Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2015; 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.