James G Fordyce, MD | |
19855 Outer Dr, Ste 204, Dearborn, MI 48124-2022 | |
(313) 565-3565 | |
(313) 565-7723 |
Full Name | James G Fordyce |
---|---|
Gender | Male |
Speciality | Allergy & Immunology - Clinical & Laboratory Immunology |
Location | 19855 Outer Dr, Dearborn, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215905765 | NPI | - | NPPES |
0H26340 | Other | MI | BLUE CROSS |
1290003 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207KI0005X | Allergy & Immunology - Clinical & Laboratory Immunology | 4301034472 (Michigan) | Primary |
Entity Name | Dearborn Allergy & Asthma Clinic Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477545200 PECOS PAC ID: 9830187210 Enrollment ID: O20040504001060 |
Mailing Address | Practice Location Address |
---|---|
James G Fordyce, MD 19855 Outer Dr, Ste 204, Dearborn, MI 48124-2022 Ph: (313) 565-3565 | James G Fordyce, MD 19855 Outer Dr, Ste 204, Dearborn, MI 48124-2022 Ph: (313) 565-3565 |
Diane L Baranowski, MD Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 19855 Outer Dr, Ste 204, Dearborn, MI 48124 Phone: 313-565-3565 Fax: 313-565-7723 | |
Ilie Magdea, MD Allergy & Immunology Medicare: Not Enrolled in Medicare Practice Location: 20200 Outer Dr, Dearborn, MI 48124 Phone: 313-565-3565 Fax: 313-565-7723 |