Healthcare Provider Details

I. General information

NPI: 1942427620
Provider Name (Legal Business Name): JOHN W STRUTHERS D O P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 SAINT ANTOINE ST SUITE 6B, BOX 254
DETROIT MI
48201-2153
US

IV. Provider business mailing address

7621 7 MILE RD
NORTHVILLE MI
48167-9126
US

V. Phone/Fax

Practice location:
  • Phone: 313-966-2609
  • Fax: 313-745-0685
Mailing address:
  • Phone: 313-966-2609
  • Fax: 313-745-0685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN W STRUTHERS
Title or Position: PRESIDENT
Credential: D.O.
Phone: 313-499-4862