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General NPI Number Information
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NPI Number | 1669653606
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Entity Type | Organization
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Legal Business Name | ASSOCIATED ORTHOPEDISTS OF DETROIT, PC
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 50505 SCHOENHERR RD SUITE 120
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-3140
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Country | US
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Telephone | 586-412-1411
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Fax | 586-412-4626
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Provider Business Mailing Address
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Address Line | 50505 SCHOENHERR RD SUITE 120
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-3140
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Country | US
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Telephone | 586-412-1411
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Fax | 586-412-4626
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | JAMIE JOHNSON
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Credential |
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Telephone | 586-710-2307
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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 |
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License Number State |
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