LORENZO FERGUSON MD PC
Medical Practice at Providence Dr, Southfield, MI

License number
Michigan LF040848
Category
Medical Practice
Type
Specialist
Owner
Name: MS. KENYA M FIFE
Title: OFFICE MANAGER
Phone: (248) 569-4228
Address
Address
22250 Providence Dr SUITE 201, Southfield, MI 48075
National Provider ID: 1770897290
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LORENZO FERGUSON M.D., PC

22250 Providence Dr, Southfield, MI 48075

Status:
Inactive
Industry:
Surgeons
Doing business as:
Lorenzo Ferguson MD
Registration:
Jul 12, 1984
Phone:
(248) 569-4228 (Phone)
State ID:
289306
Business type:
Domestic Professional Service Corporation
Expiration:
8-20-2014
Lorenzo Ferguson
Agent:
Dr Lorenzo Ferguson

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