Provider Demographics
NPI:1104352319
Name:FERREIRA, CLIFF R
Entity type:Individual
Prefix:
First Name:CLIFF
Middle Name:R
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N MONROE ST
Mailing Address - Street 2:SUITE #319
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-2972
Mailing Address - Country:US
Mailing Address - Phone:734-241-3900
Mailing Address - Fax:
Practice Address - Street 1:730 N MONROE ST
Practice Address - Street 2:SUITE #319
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2972
Practice Address - Country:US
Practice Address - Phone:734-241-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-08
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704261947363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner