NPIMap

Individual provider Active NPI

Wisam George, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • West Bloomfield, MI
National Provider Identifier
1790989317
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
L1130895 Issued in MI
Practice address
2300 Haggerty Rd
Suite 2100
West Bloomfield, MI 48323-2184
Phone
(248) 624-7246
Fax
(248) 624-2597
NPI assigned
Jun 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 5315031019 MI
Pain Medicine (Anesthesiology) Physician 207LP2900X L1130895 MI Primary

Addresses

Primary practice location

2300 Haggerty Rd
Suite 2100
West Bloomfield, MI 48323-2184

Mailing address

32255 Northwestern Hwy Ste 165
Farmington Hills, MI 48334-1505
Phone (248) 735-8272

Other names 1

  • Dr. Sam George Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081217000485 MI Practitioner - AnesthesiologyPractitioner - Pain Management 7214099738 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Michigan State University College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

32255 Northwestern Hwy
Suite 145
Farmington Hills, MI 48334-1578
Phone (248) 539-3027

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5315031019MIMDPain Medicine (Anesthesiology) Physician
L1130895MIMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Interventional Pain Center,PC Multi-Specialty CurrentSince Jul 1, 2016 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Mar 1, 2025 Accepting new patients
Michigan Healthcare Professionals PC Multi-Specialty CurrentSince Mar 1, 2025 Accepting new patients
Southern Michigan Pain Consultants PC Multi-Specialty CurrentSince Jan 10, 2022 Accepting new patients
Radius Anesthesia of Michigan PLLC Multi-Specialty CurrentSince Feb 1, 2022 Accepting new patients
Anesthesia Services Associates, PC Multi-Specialty CurrentSince Jul 15, 2008 Accepting new patients
Integrated Physician Solutions PC PastSince Aug 1, 2016 Accepting new patients
Waterford Surgical Center, LLC Past Accepting new patients

Locations

19725 Allen Rd
Ste A
Brownstown Twp, MI 48183
Phone 3132776700316

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

24430 Ford Rd
Ste A
Dearborn Heights, MI 48127
Phone (313) 274-1292

24420 Ford Rd
Dearborn Heights, MI 48127
Phone (313) 202-9400

32255 Northwestern Hwy
Ste 165
Farmington Hills, MI 48334
Phone (248) 735-8272

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

32255 Northwestern Hwy
Ste 145
Farmington Hills, MI 48334
Phone (248) 539-3027

32255 Northwestern Hwy
Ste 135
Farmington Hills, MI 48334
Phone (248) 885-4163

3770 Glenkerry Ct
Portage, MI 49024
Phone (269) 329-2887

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100

31235 Harper Ave
St Clr Shores, MI 48082
Phone (267) 817-8902

4600 Investment Dr
Ste 270
Troy, MI 48098
Phone (248) 267-6222

11650 Belleville Rd
Ste 105
Van Buren Township, MI 48111
Phone (734) 325-6282

5220 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 461-2800

5220 Highland Rd
Ste 1
Waterford, MI 48327
Phone (248) 886-5555

2300 Haggerty Rd
Ste 2100
West Bloomfield, MI 48323
Phone (248) 624-7246

2300 Haggerty Rd
Ste 1000
West Bloomfield, MI 48323
Phone (248) 896-6300

111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700

Interoperability endpoints

  • Direct secure messaging: wgeorge1633808@direct.trinity-health.org
  • Direct secure messaging: wgeorge1129847@direct.hfhs.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1790989317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32255 NORTHWESTERN HWY STE 165",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341505",
            "telephone_number": "248-735-8272",
            "fax_number": "248-735-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD",
            "address_2": "SUITE 2100",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232184",
            "telephone_number": "248-624-7246",
            "fax_number": "248-624-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "WISAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "5315031019",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "L1130895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAM",
            "last_name": "GEORGE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.