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SANDUSKY SURGICAL PLLC
NPI 1093762742
Clinic/Center in Sandusky, MI

Active since May 28, 2006
150 N DELAWARE ST, SANDUSKY, MI 48471(810) 648-9670(810) 648-9677 Get Directions Write a Review

NPPES record last updated: January 3, 2008. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Sandusky Surgical Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANDUSKY SURGICAL PLLC (NPI 1093762742) is a healthcare organization registered as a clinic/center in Sandusky, Michigan and active in the NPI registry since May 2006. The organization lists Khristine C Botezan, President, as its authorized official.

NPPES Registry Identity

NPI1093762742
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSANDUSKY SURGICAL PLLC
Location Address150 N DELAWARE STSandusky, MI 48471-1009
Mailing AddressPo Box 191Sandusky, MI 48471-0191 · (810) 648-9670 · Fax (810) 648-9677
Phone(810) 648-9670
Fax(810) 648-9677
Organization SubpartNo
Authorized OfficialKhristine C BotezanPresident · (810) 648-9670
Enumeration DateMay 28, 2006
Last NPPES UpdateJanuary 3, 2008
✔ NPI 1093762742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in MI · 4301084929
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
150 N DELAWARE ST, Sandusky, MI 48471
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Other Identifiers 3

Medicaid4700615MI
Medicare PIN0P27190MI
Medicare UPINF55326MI

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KHRISTINE C BOTEZAN MD
Surgery
150 N DELAWARE ST
SANDUSKY, MI 48471
Sanilac County (810) 648-9670

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sandusky Surgical PLLC's NPI number?

The NPI number for Sandusky Surgical PLLC is 1093762742. It was assigned to this organization in the NPPES registry on May 28, 2006.

Where is Sandusky Surgical PLLC located?

Sandusky Surgical PLLC is located at 150 N Delaware St, Sandusky, MI 48471. The listed phone number is (810) 648-9670.

What is Sandusky Surgical PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Sandusky Surgical PLLC was last updated on January 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.