Individual
ROBERT MYRON FEDOROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(586) 524-0854
Mailing address
1506 STREAMWOOD CT, ROCHESTER HILLS, MI 48309-3389
(586) 524-0854
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704280907
MI
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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