# COMMUNITY ORTHOPEDIC SURGERY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104867910
- **Authorized official:** MRS. SANDRA D BOLTON (BILLING MANAGER)
- **Authorized official phone:** (734) 712-0635

## Contact information

- **Practice address:** 5315 ELLIOTT DR, SUITE 202, YPSILANTI, MI 48197-8634
- **Practice address phone:** (734) 712-0600
- **Practice address fax:** (734) 712-0522
- **Mailing address:** 5315 ELLIOTT DR, SUITE 202, YPSILANTI, MI 48197-8634
- **Mailing address phone:** (734) 712-0600
- **Mailing address fax:** (734) 712-0522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | RN043612 | MI | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 06/20/2008