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General NPI Number Information
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NPI Number | 1548353162
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC SURGERY AND SPORTS MEDICINE
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 43281 COMMONS DRIVE
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038
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Country | US
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Telephone | 586-286-0670
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Fax |
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Provider Business Mailing Address
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Address Line | 43281 COMMONS DRIVE
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038
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Country | US
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Telephone | 586-286-0670
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN P FERRIS SR.
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Credential | DO
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Telephone | 586-286-0670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | JF004878
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License Number State | MI
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