Organization
FERRARA DERMATOLOGY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD JOHN FERRARA JR M.D. (OWNER)
(313) 884-5100
Entity
Organization
Contact information
Practice address
20045 MACK AVE, GROSSE POINTE WOODS, MI 48236-2322
(313) 884-5100
Mailing address
20045 MACK AVE, GROSSE POINTE WOODS, MI 48236-2322
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301057129
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2774745
—
MI
Enumeration date
09/27/2006
Last updated
08/22/2020
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