Provider Demographics
NPI:1245260959
Name:METROPOLITAN ORTHOPAEDIC ASSOCIATES, P.C.
Entity type:Organization
Organization Name:METROPOLITAN ORTHOPAEDIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FABBIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-881-4900
Mailing Address - Street 1:16815 E JEFFERSON AVE
Mailing Address - Street 2:SUITE #150
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1923
Mailing Address - Country:US
Mailing Address - Phone:313-881-4900
Mailing Address - Fax:313-881-4901
Practice Address - Street 1:16815 E JEFFERSON AVE
Practice Address - Street 2:SUITE #150
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48230-1923
Practice Address - Country:US
Practice Address - Phone:313-881-4900
Practice Address - Fax:313-881-4901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI070098207X00000X
MI5501010708225100000X
MI5101013938207X00000X
MI033007207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIG55164Medicare UPIN
MIH95741Medicare UPIN
MIA73571Medicare UPIN
MI0N78760Medicare ID - Type Unspecified
MI0483290002Medicare NSC