Provider Demographics
NPI:1962465880
Name:FERRARA, MICHAEL S (PHD, ATC)
Entity Type:Individual
Prefix:PROF
First Name:MICHAEL
Middle Name:S
Last Name:FERRARA
Suffix:
Gender:M
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE UNIVERSITY OF GEORGIA
Mailing Address - Street 2:300 RIVER ROAD
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602-6554
Mailing Address - Country:US
Mailing Address - Phone:706-542-4801
Mailing Address - Fax:706-583-0033
Practice Address - Street 1:THE UNIVERSITY OF GEORGIA
Practice Address - Street 2:300 RIVER ROAD
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-6554
Practice Address - Country:US
Practice Address - Phone:706-542-4801
Practice Address - Fax:706-583-0033
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0010382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer