# SELECT MEDICAL GROUP OF MICHIGAN PLLC

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

## Provider details

- **NPI number:** 1609435056
- **Authorized official:** DR. EDRICK J FERGUSON M.D. (MANAGER)
- **Authorized official phone:** (248) 307-7781

## Contact information

- **Practice address:** 23350 GREENFIELD RD STE 200, OAK PARK, MI 48237-2496
- **Practice address phone:** (248) 307-7781
- **Practice address fax:** (248) 302-7782
- **Mailing address:** 23350 GREENFIELD RD STE 200, OAK PARK, MI 48237-2496
- **Mailing address phone:** (248) 307-7781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/10/2019
- **Last updated:** 06/10/2019