Fordyce, James G

Fordyce, James G is an individual health care provider with primary practice located at 19855 Outer Dr Ste 204, Dearborn MI 48124-2022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology, which is considered as his primary health care specialty. Fordyce, James G can be contacted via phone (313) 565-3565.

Contact Information

Primary practice address
19855 Outer Dr Ste 204 Dearborn MI 48124-2022
Phone: (313) 565-3565
Fax: (313) 565-7723
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology 207KI0005X 4301034472 Michigan

Profile Details

NPI number 1215905765
LBN Legal business name Fordyce, James G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2006
Last updated Jun 22nd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215905765 NPPES
Michigan Other 0H26340 BLUE CROSS
Michigan MEDICAID 1290003 BLUE CROSS

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