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Individual

DR. ROBERT B FERGUSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., P.C

Contact information

Practice address
4256 ORCHARD LAKE RD, WEST BLOOMFIELD, MI 48323-1645
(248) 682-1720
(248) 682-9289
Mailing address
758 WOODCHESTER, WEST BLOOMFIELD, MI 48304
(248) 408-2170
(248) 723-5874

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301058431
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
124607
GREAT LAKES HEALTH PLAN
MI
05
3310704
MI
Enumeration date
11/13/2006
Last updated
07/08/2007
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