Organization
GENESIS MD, PLLC
Active
Organization
GENESIS MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDRICK FERGUSON MD (OWNER)
(313) 581-3255
Entity
Organization
Contact information
Practice address
8560 N SILVERY LN STE 101, DEARBORN HEIGHTS, MI 48127-4516
(313) 581-3255
Mailing address
8560 N SILVERY LN STE 202, DEARBORN HEIGHTS, MI 48127-4515
(313) 581-3255
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/26/2019
Last updated
05/15/2019
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