Individual
BRIAN PAUL FEDORONKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24 FRANK LLOYD WRIGHT DR, SUITE L 2200, ANN ARBOR, MI 48105-9484
(734) 930-4020
(734) 769-8948
Mailing address
24 FRANK LLOYD WRIGHT DR, SUITE L 2200, ANN ARBOR, MI 48105-9484
(734) 930-4020
(734) 769-8948
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301063578
MI
208000000X
Pediatrics Physician
4301063578
MI
Other
Enumeration date
08/03/2006
Last updated
03/16/2017
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