Provider Demographics
NPI:1912969700
Name:FERIK, ELIZABETH S (DO)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:FERIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:2316 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3152
Practice Address - Country:US
Practice Address - Phone:517-702-4300
Practice Address - Fax:517-702-4301
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101014624207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1016412OtherMCLAREN HEALTH PLAN
MI160C311260OtherBLUE CROSS BLUE SHIELD
MI4794596Medicaid
MI7897757OtherAETNA
MI160C311260OtherBLUE CHOICE
MI1653311355OtherBLUE CROSS BLUE SHIELD
MI1016412OtherHEALTH ADVANTAGE
MI160C311260OtherBLUE CARE NETWORK
MII44110OtherHEALTH NET FEDERAL SERVIC
MI0700436OtherPHYSICIANS HEALTH PLAN
MI160C311260OtherCOMMUNITY CHOICE
MII44110Medicare UPIN
MION10280008Medicare ID - Type Unspecified