Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Great Lakes Surgical Assistants, PLLC

Organization Surgical Physician Assistant · NPI 1558653303

Great Lakes Surgical Assistants, PLLC is a Surgical Physician Assistant in Troy, Michigan. Licensed in Michigan. Registered with an NPI since 2011.

Licensed in
MI
In the registry since
2011
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4550 Investment Dr Ste 100
Troy, MI 48098-6334
Phone: (248) 265-4600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence D5298K (MI)

Record details

NPI number1558653303
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brandon Mackenzie — Owner, Pa-C · (586) 246-5125
NPI enumeratedMay 12, 2011
Last updated in NPPESJuly 21, 2011
Mailing address47120 Land St, Chesterfield, MI 48047-5142

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