PORT HURON BONE AND JOINT SURGERY PC NPI 1861002131

Orthopaedic Surgery in Marysville, MI

NPI 1861002131 Organization Orthopaedic Surgery

About PORT HURON BONE AND JOINT SURGERY PC

Port Huron Bone And Joint Surgery Pc is a provider established in Marysville, Michigan specializing in orthopaedic surgery. The NPI number of Port Huron Bone And Joint Surgery Pc is 1861002131 and was assigned on August 2020. The practitioner's primary taxonomy code is 207X00000X. The provider is registered as an organization and their NPI record was last updated one year ago. Port Huron Bone And Joint Surgery Pc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Robert D Travis Md (Owner)

NPI

1861002131

Provider NamePORT HURON BONE AND JOINT SURGERY PC
Provider Location Address1985 GRATIOT BLVD MARYSVILLE, MI 48040
Provider Mailing Address1330 CONGE DR BLOOMFIELD HILLS, MI 48304
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date08-03-2020
Last Update Date09-18-2020


Primary Taxonomy

Taxonomy Code207X00000X
ClassificationOrthopaedic Surgery
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Business Address

PORT HURON BONE AND JOINT SURGERY PC
1985 GRATIOT BLVD
MARYSVILLE, MI
ZIP 48040
Phone: (734) 451-9692
Fax: (734) 451-9606

Get Directions


Mailing Address

PORT HURON BONE AND JOINT SURGERY PC
1330 CONGE DR
BLOOMFIELD HILLS, MI
ZIP 48304
Phone: (734) 451-9692
Fax: (734) 451-9606



Authorized Official

Authorized Official Name ROBERT D TRAVIS MD
Authorized Official TitleOWNER
Authorized Official Phone(734) 451-9692

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1861002131MEDICAID (05)MI

Other Providers at the same location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1790750685 MARY CRACIUM DO
Individual
Family Medicine1985 GRATIOT BLVD SUITE 2A
MARYSVILLE, MI 48040
(810) 364-5050
1518917491 AMGAD NASHED-AWAD MD
Individual
Family Medicine1985 GRATIOT BLVD SUITE 2A
MARYSVILLE, MI 48040
(810) 364-5050
1023297967DR. RIGEL GALERA M.D.
Individual
Family Medicine1985 GRATIOT BLVD SUITE 2A
MARYSVILLE, MI 48040
(810) 364-5050
1073841011 TYNISE LA'SHAIE PENN N.P.
Individual
Nurse Practitioner1985 GRATIOT BLVD SUITE 2A
MARYSVILLE, MI 48040
(810) 364-5050
1972899680DR. ARUNTHATHI TABITHA STALLWOOD MD
Individual
Internal Medicine1985 GRATIOT BLVD
MARYSVILLE, MI 48040
(810) 364-0692
1740275981DR. JAMES STERLING CABEEN DO
Individual
Family Medicine1985 GRATIOT BLVD STE 2A
MARYSVILLE, MI 48040
(810) 364-5050

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.