Organization
ORTHOPEDIC SURGERY AND SPORTS MEDICINE
Active
Organization
ORTHOPEDIC SURGERY AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P FERRIS SR. DO (PRESIDENT)
(586) 286-0670
Entity
Organization
Contact information
Practice address
43281 COMMONS DRIVE, CLINTON TOWNSHIP, MI 48038
(586) 286-0670
Mailing address
43281 COMMONS DRIVE, CLINTON TOWNSHIP, MI 48038
(586) 286-0670
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
JF004878
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119353
GREAT LAKES HEALTH CARE
MI
01
—
4622217
AETNA
MI
01
—
NC010517
MCARE
MI
Enumeration date
10/02/2006
Last updated
08/22/2020
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