Organization
SOUTHEASTERN ORTHOPEDICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN P SOMERS (SUPERVISOR)
(517) 265-0229
Entity
Organization
Contact information
Practice address
770 RIVERSIDE AVE, STE 105, ADRIAN, MI 49221-1476
(517) 265-5230
Mailing address
770 RIVERSIDE AVE, STE 105, ADRIAN, MI 49221-1476
(517) 265-5230
(517) 265-1535
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2004611141
BCBS
MI
05
—
4180319
—
MI
Enumeration date
02/08/2008
Last updated
06/27/2008
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