Basic Information
| Provider Information | |||||||||
| NPI: | 1811166762 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DEBORA L. FERGUSON, M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43996 WOODWARD AVE STE 102 | ||||||||
| Address2: | |||||||||
| City: | BLOOMFIELD HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483025028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483351711 | ||||||||
| FaxNumber: | 2483357950 | ||||||||
| Practice Location | |||||||||
| Address1: | 43996 WOODWARD AVE STE 102 | ||||||||
| Address2: | |||||||||
| City: | BLOOMFIELD HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483025028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483351711 | ||||||||
| FaxNumber: | 2483357950 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2008 | ||||||||
| LastUpdateDate: | 02/25/2008 | ||||||||
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| AuthorizedOfficialLastName: | FERGUSON | ||||||||
| AuthorizedOfficialFirstName: | DEBORA | ||||||||
| AuthorizedOfficialMiddleName: | L. | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 2483351711 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 407595 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.