Organization
MICHIGAN CENTER FOR ORTHOPEDIC SURGERY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIVAJEE V NALLAMOTHU D. O. (OWNER)
(248) 620-2325
Entity
Organization
Contact information
Practice address
17200 SILVER PKWY, FENTON, MI 48430-3423
(810) 714-9660
(810) 714-9661
Mailing address
5701 BOW POINTE DR, STE 300, CLARKSTON, MI 48346-3198
(248) 620-2325
(248) 620-2326
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
07/08/2008
Last updated
03/08/2012
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