| Roy Frederick Small, DO | |
|
1000 Harrington St, Mount Clemens, MI 48043-2920 | |
| (586) 493-8142 | |
| (586) 493-3250 |
| Full Name | Roy Frederick Small |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery |
| Location | 1000 Harrington St, Mount Clemens, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447746318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 11021502A (Indiana) | Secondary |
| 207X00000X | Orthopaedic Surgery | 5151013215 (Michigan) | Primary |
| Entity Name | Orthopaedics Northeast Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740268796 PECOS PAC ID: 9234024878 Enrollment ID: O20040405001087 |
| Mailing Address | Practice Location Address |
|---|---|
| Roy Frederick Small, DO 1000 Harrington St, Mount Clemens, MI 48043-2920 Ph: (586) 493-3727 | Roy Frederick Small, DO 1000 Harrington St, Mount Clemens, MI 48043-2920 Ph: (586) 493-8142 |
Nicholas Joseph Michel, DO Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8000 | |
Saad Mohammad, DO Orthopedic Surgery Medicare: May Accept Medicare Assignments Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8142 Fax: 586-493-3250 | |
Baraa Ghassan Mussallam, DO Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-790-9003 | |
Dr. Michael Anthony Wagner, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8000 | |
Michael Dirkx, D.O. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8000 | |
Phillip Anderson, DO Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-790-9003 |