| NPI | 1801992557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH STARKEL Supervisor 248-680-8121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: MI 5901002120) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5901002120) |
| 213ES0000X Podiatrist Sports Medicine (Licence: MI 5901002120) | |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MI 5901002120) | |
| 213ES0131X Podiatrist Foot Surgery (Licence: MI 5901002120) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2023-11-29 |