Provider Demographics
NPI:1649322454
Name:ADVANCED ORTHOPEDIC SPECIALISTS PC
Entity type:Organization
Organization Name:ADVANCED ORTHOPEDIC SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LAITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:FARJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-299-8550
Mailing Address - Street 1:2305 GENOA BUSINESS PARK DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7004
Mailing Address - Country:US
Mailing Address - Phone:810-299-8550
Mailing Address - Fax:810-844-0837
Practice Address - Street 1:2305 GENOA BUSINESS PARK DR
Practice Address - Street 2:SUITE 170
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7367
Practice Address - Country:US
Practice Address - Phone:810-299-8550
Practice Address - Fax:810-844-0837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICJ6871Medicare PIN
MI0N41740Medicare PIN