Organization
ADRIAN ORTHOPEDICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY DETTMAN (BILLING SPECIALIST)
(517) 265-0208
Entity
Organization
Contact information
Practice address
693 STOCKFORD DR, ADRIAN, MI 49221-1460
(517) 265-0208
Mailing address
693 STOCKFORD DR, ADRIAN, MI 49221-1460
(517) 264-0756
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101011992
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054600214
BCBS
MI
05
—
4240749
—
MI
Enumeration date
05/08/2008
Last updated
07/07/2008
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