Provider Demographics
NPI:1700900032
Name:TONNOS, FREDERICK E (DO)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:E
Last Name:TONNOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WILLIAM CARLS DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-2201
Mailing Address - Country:US
Mailing Address - Phone:248-937-4947
Mailing Address - Fax:248-937-4947
Practice Address - Street 1:1 WILLIAM CARLS DR
Practice Address - Street 2:SUITE 120
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-2201
Practice Address - Country:US
Practice Address - Phone:248-937-4947
Practice Address - Fax:248-937-4947
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016566207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1504053Medicare UPIN
MIMI1503053Medicare UPIN
MIMI1504Medicare PIN
MIMI1503Medicare PIN