Genesis Md, Pllc
NPI #1982165619 in Dearborn Heights, Michigan
Provider Information
- NPI Number
- 1982165619
- Entity Type
- Organization
- Organization Name
- Genesis Md, Pllc
- Primary Specialty
- Pain Medicine - Interventional Pain Medicine
- Enumeration Date
- Mar 26, 2019
- Last Updated
- May 15, 2019
Practice Location
- Address
- 8560 N SILVERY LN STE 101
- City
- Dearborn Heights
- State
- Michigan
- ZIP Code
- 48127-4516
- Phone
- (313) 581-3255
Authorized Official
- Name
- EDRICK FERGUSON, MD
- Title
- OWNER
- Phone
- (313) 581-3255
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pain Medicine - Interventional Pain Medicine — Interventional Pain Medicine |
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