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Individual

MICHAEL THOMAS FRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
25631 LITTLE MACK AVE STE 102, SAINT CLAIR SHORES, MI 48081-2100
(586) 443-2317
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301514816
MI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
A196123
CA

Other

Enumeration date
04/11/2018
Last updated
11/04/2025
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