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Individual
MR. MICHAEL THOMAS FERGUSON
Active
Individual
MR. MICHAEL THOMAS FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2719
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05113
SPECTARA
FL
01
—
10047
NVA
FL
01
—
10451
SVS FORD
FL
01
—
2449
DAVIS
FL
01
—
38742
AVESIS
FL
Enumeration date
05/25/2007
Last updated
07/08/2007
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