Healthcare Provider Details

I. General information

NPI: 1235117318
Provider Name (Legal Business Name): MARY M ORDING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W GREENLAWN AVE
LANSING MI
48910-2819
US

IV. Provider business mailing address

401 S BALLENGER HWY
FLINT MI
48532-3638
US

V. Phone/Fax

Practice location:
  • Phone: 517-337-8396
  • Fax:
Mailing address:
  • Phone: 810-342-1000
  • Fax: 810-342-1590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301063002
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: