Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Great Lakes Surgical Assistants, PLLC

Organization Surgical Physician Assistant · NPI 1558653303

Great Lakes Surgical Assistants, PLLC provides Surgical Physician Assistant services 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 Not confirmed with CMS for 15 years — call before visiting
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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