NPIMap

Organization Active NPI

Midland Surgical Group PC

  • Surgery Physician
  • Midland, MI
National Provider Identifier
1689662926
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
040961 Issued in MI
Legal business name
MIDLAND SURGICAL GROUP PC
Practice address
4007 Orchard Dr
Suite 2003
Midland, MI 48640-6187
Phone
(989) 631-1221
Fax
(989) 631-6686
NPI assigned
Oct 11, 2005
Last updated
Oct 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Authorized official

Name
Ellsworth Emil Ludwig, MDNPI 1689663510
Title
President
Phone
(989) 631-1221

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 040961 MI Primary
Surgery Physician 208600000X 047857 MI

Addresses

Primary practice location

4007 Orchard Dr
Suite 2003
Midland, MI 48640-6187

Mailing address

4007 Orchard Dr
Suite 2003
Midland, MI 48640-6190
Phone (989) 631-1221

Other identifiers 1

IdentifierTypeStateIssuer
020E66017OtherMIBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1689662926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 ORCHARD DR",
            "address_2": "SUITE 2003",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406190",
            "telephone_number": "989-631-1221",
            "fax_number": "989-631-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 ORCHARD DR",
            "address_2": "SUITE 2003",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406187",
            "telephone_number": "989-631-1221",
            "fax_number": "989-631-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND SURGICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "LUDWIG",
        "authorized_official_first_name": "ELLSWORTH",
        "authorized_official_middle_name": "EMIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-631-1221",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "040961",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "047857",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "020E66017",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.