Healthcare Provider Details

I. General information

NPI: 1134839103
Provider Name (Legal Business Name): SARDELLI ORTHOPAEDICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5680 BOW POINTE DR STE 102
CLARKSTON MI
48346-5407
US

IV. Provider business mailing address

5701 BOW POINTE DR STE 300
CLARKSTON MI
48346-5402
US

V. Phone/Fax

Practice location:
  • Phone: 248-792-0037
  • Fax: 248-795-5714
Mailing address:
  • Phone: 248-379-4246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW SARDELLI
Title or Position: OWNER
Credential: MD
Phone: 248-379-4246