Provider Demographics
NPI:1730279191
Name:FERRARI, DONALD R I (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:R
Last Name:FERRARI
Suffix:I
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35517 HATHERLY PL
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5139
Mailing Address - Country:US
Mailing Address - Phone:586-979-8184
Mailing Address - Fax:
Practice Address - Street 1:ST. JOHN HEALTH SYSTEM
Practice Address - Street 2:22101 MOROSS RD.
Practice Address - City:DETROIT RD.
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-343-4753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine