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Organization
GENESIS MD DIAGNOSTIC IMAGING PC
Active
Organization
GENESIS MD DIAGNOSTIC IMAGING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDRICK FERGUSON M.D. (OWNER)
(313) 581-3255
Entity
Organization
Contact information
Practice address
8560 N SILVERY LN STE 101, DEARBORN HEIGHTS, MI 48127-4516
(313) 581-3255
(313) 581-3755
Mailing address
8560 N SILVERY LN STE 101, DEARBORN HEIGHTS, MI 48127-4516
(313) 581-3255
(313) 581-3755
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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