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NPI 1104352319

NPI 1104352319 : CLIFF R. FERREIRA : MONROE, MI

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General NPI Number Information
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    NPI Number           |    1104352319
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    Entity Type          |    Individual 
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    Provider Name        |    CLIFF R. FERREIRA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/08/2017
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    Last Update Date     |    11/03/2023
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Provider Practice Location Address
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    Address Line         |    730 N MONROE ST SUITE #319
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    City                 |    MONROE
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    State                |    MI
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    Zip                  |    48162-2972
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    Country              |    US
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    Telephone            |    734-241-3900
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    730 N MONROE ST SUITE #319
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    City                 |    MONROE
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    State                |    MI
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    Zip                  |    48162-2972
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    Country              |    US
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    Telephone            |    734-241-3900
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    4704261947
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    License Number State |    MI
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