Genesis MD, PLLC
Pain Medicine, Interventional Pain Medicine in Dearborn Heights, MI. Organization (NPI-2).
NPI number1982165619
StatusActive
Last updated in NPPESMay 15, 2019
Details
- NPI
- 1982165619
- Entity type
- Organization (NPI-2)
- Legal business name
- Genesis MD, PLLC
- Organization subpart
- No
- Enumeration date
- Mar 26, 2019
- Last updated
- May 15, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | – | – | Yes |
Practice location
8560 N Silvery Ln Ste 101Dearborn Heights, MI 48127-4516
Phone 313-581-3255
Mailing address
8560 N Silvery Ln Ste 202Dearborn Heights, MI 48127-4515
Phone 313-581-3255
Authorized official
Edrick Ferguson
Owner
3135813255
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