Healthcare Provider Details

I. General information

NPI: 1013185255
Provider Name (Legal Business Name): GENERAL ORTHOPEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 HIGHLAND RD
WATERFORD MI
48328-1176
US

IV. Provider business mailing address

4800 HIGHLAND RD
WATERFORD MI
48328-1176
US

V. Phone/Fax

Practice location:
  • Phone: 248-673-0500
  • Fax: 248-673-6077
Mailing address:
  • Phone: 248-673-0500
  • Fax: 248-673-6077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. CATHERINE L HYPIO
Title or Position: ASSISTANT MANAGER
Credential: CMIS
Phone: 248-673-0500