Organization
GENESIS HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDRICK FERGUSON (OWNER)
(313) 636-2290
Entity
Organization
Contact information
Practice address
8560 N SILVERY LN STE 101, DEARBORN HEIGHTS, MI 48127-4516
(313) 636-2290
Mailing address
8560 N SILVERY LN STE 101, DEARBORN HEIGHTS, MI 48127-4516
(313) 636-2290
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
03/25/2019
Last updated
03/25/2019
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