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General NPI Number Information
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NPI Number | 1255704268
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Entity Type | Organization
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Legal Business Name | PELVIS AND ACETABULUM SURGICAL SPECIALISTS, PLLC
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 50297 DRAKES BAY DR
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City | NOVI
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State | MI
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Zip | 48374-2544
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Country | US
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Telephone | 248-343-8268
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Fax |
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Provider Business Mailing Address
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Address Line | 50297 DRAKES BAY DR
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City | NOVI
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State | MI
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Zip | 48374-2544
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | FREDERICK TONNOS
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Credential |
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Telephone | 248-343-8268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | 5101016566
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License Number State | MI
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