Provider Demographics
NPI:1821158387
Name:ORTHOPEDIC SPECIALISTS PC
Entity Type:Organization
Organization Name:ORTHOPEDIC SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YURKANIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-675-2640
Mailing Address - Street 1:5400 FORT STREET
Mailing Address - Street 2:SUITE 150
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183
Mailing Address - Country:US
Mailing Address - Phone:734-675-2640
Mailing Address - Fax:734-675-2812
Practice Address - Street 1:5400 FORT STREET
Practice Address - Street 2:SUITE 150
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183
Practice Address - Country:US
Practice Address - Phone:734-675-2640
Practice Address - Fax:734-675-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2088201164OtherBCN
14822OtherM CARE
121478OtherPREFERRED CHOICES
7914OtherCAPE
4038287OtherAETNA
821202OtherPRO CARE
2088201164OtherBCBS
48781OtherOMNI
763306OtherPENNSYLVANIA BCBS
121478OtherCARE CHOICES HMO
821202OtherPRO CARE
763306OtherPENNSYLVANIA BCBS
48781OtherOMNI
14822OtherM CARE
2088201164OtherBCBS