Provider Demographics
NPI:1093392243
Name:RONALD S LEDERMAN, MD, PLLC
Entity Type:Organization
Organization Name:RONALD S LEDERMAN, MD, PLLC
Other - Org Name:LEDERMAN KWARTOWITZ CENTER FOR ORTHOPEDICS & SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-669-2000
Mailing Address - Street 1:2300 HAGGERTY RD STE 1110
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2185
Mailing Address - Country:US
Mailing Address - Phone:248-669-2000
Mailing Address - Fax:248-669-2110
Practice Address - Street 1:31500 TELEGRAPH RD STE 235
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4315
Practice Address - Country:US
Practice Address - Phone:248-669-2000
Practice Address - Fax:248-669-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty