Michael L Douglass, AA | |
36500 Aurora Dr, Summit, WI 53066-4899 | |
(262) 434-1000 | |
Not Available |
Full Name | Michael L Douglass |
---|---|
Gender | Male |
Speciality | Anesthesiology Assistant |
Experience | 3 Years |
Location | 36500 Aurora Dr, Summit, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154070738 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | 209-17 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Aurora Medical Center - Summit | Summit, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Aurora Medical Group, Inc. | 6709794258 | 3269 |
Entity Name | Aurora Medical Group, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Mailing Address | Practice Location Address |
---|---|
Michael L Douglass, AA 36500 Aurora Dr, Summit, WI 53066-4899 Ph: (262) 434-1000 | Michael L Douglass, AA 36500 Aurora Dr, Summit, WI 53066-4899 Ph: (262) 434-1000 |
Mary K Duffy, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-434-1000 | |
Anthony James Sawall, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-434-1000 Fax: 262-434-5050 | |
Mikayla Nicole Ehlert, AA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-434-1000 Fax: 262-434-5050 | |
Victoria M Sawall, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 36500 Aurora Dr, Summit, WI 53066 Phone: 262-434-1000 Fax: 262-434-5050 |