Healthcare Provider Details

I. General information

NPI: 1609831775
Provider Name (Legal Business Name): ORTHOPEDIC SURGERY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5315 ELLIOTT DR STE 301
YPSILANTI MI
48197-8634
US

IV. Provider business mailing address

5315 ELLIOTT DR STE 301
YPSILANTI MI
48197-8634
US

V. Phone/Fax

Practice location:
  • Phone: 734-572-4500
  • Fax: 734-572-4503
Mailing address:
  • Phone: 734-572-4500
  • Fax: 734-572-4503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN L KOLMAN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 734-572-4565