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Contact Information

ORTHOPEDIC SURGERY AND SPORTS MEDICINE
43281 COMMONS DRIVE
CILNTON TOWNSHIP, MI48038
 Phone: 586-286-0670
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for ORTHOPEDIC SURGERY AND SPORTS MEDICINE · (Female)

NPI # 1548353162
Status Active
Credentials
Entity Individual
Enumeration date 10/02/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MI License # JF004878
  • MI Other 4622217 AETNA
  • MI Other 119353 GREAT LAKES HEALTH CARE
  • MI Other NC010517 MCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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