Provider Demographics
NPI:1952490278
Name:FERRON, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:FERRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 781389
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1389
Mailing Address - Country:US
Mailing Address - Phone:440-354-0377
Mailing Address - Fax:440-354-9368
Practice Address - Street 1:9500 MENTOR AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-8713
Practice Address - Country:US
Practice Address - Phone:440-354-0377
Practice Address - Fax:440-354-9368
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-047009208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0483481Medicaid
OH0547744Medicare PIN
OHC 02729Medicare UPIN