Organization
DAVENPORT FERGUSON PHYSICIAN GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARGO KIMBERLEE FERGUSON MD (OWNER/PHYSICIAN)
(248) 968-4470
Entity
Organization
Contact information
Practice address
15565 NORTHLAND DR, SUITE 204, SOUTHFIELD, MI 48075-5310
(248) 423-4477
(248) 423-4488
Mailing address
15565 NORTHLAND DR, SUITE 204, SOUTHFIELD, MI 48075-5310
(248) 423-4477
(248) 423-4488
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301061334
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080F300760
BCN
MI
05
—
4495238-10
—
MI
Enumeration date
12/05/2005
Last updated
06/25/2008
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