Healthcare Provider Details

I. General information

NPI: 1699798215
Provider Name (Legal Business Name): FRANKLIN S FERRES P.A.-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11051 HALL RD STE 200
UTICA MI
48317-5742
US

IV. Provider business mailing address

20952 E 12 MILE RD STE 200
SAINT CLAIR SHORES MI
48081-3203
US

V. Phone/Fax

Practice location:
  • Phone: 586-254-5759
  • Fax: 586-254-5793
Mailing address:
  • Phone: 586-771-4820
  • Fax: 586-771-7960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601001460
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: