person
Dr. George Daniel Shanahan IV, DPM
Foot & Ankle Surgery Podiatrist in Commerce Twp, Michigan
NPI 1003818907

George Daniel Shanahan IV is a Foot & Ankle Surgery Podiatrist based in Commerce Twp, MI and is specialized in Foot & Ankle Surgery. George Daniel Shanahan IV practices in Commerce Twp, MI and has the professional credentials of DPM. The NPI Number for George Daniel Shanahan IV is 1003818907 and holds a License No. GDS001605 (Michigan).

The current practice location address for George Daniel Shanahan IV is 9640 Commerce Rd Ste 102, Commerce Twp, MI and can be reached out via phone at 248-360-3888 and via fax at 248-363-0894.

Location: 9640 Commerce Rd Ste 102, Commerce Twp, MI, 48382-4167
person
Provider Profile Details
NPI Number
1003818907
Provider Name
George Daniel Shanahan IV
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
9640 Commerce Rd Ste 102, Commerce Twp, MI, 48382-4167
Phone Number
248-360-3888
Fax Number
248-363-0894
Provider Enumeration Date
08/11/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
38-3128264 01 TAX ID
130147 01 MI CARE CHOICES
GDS001605 01 MI STATE LICENSE
5631126 01 MA BLUE CROSS BLUE SHIELD
U43179 01 MI HAP
297370213 05 MI
4778520001 01 DME ADMINISTAR FEDERAL
institution
Provider Business Practice Location Address Details
Address
9640 Commerce Rd Ste 102
City
State
Zip
48382-4167
Phone Number
248-360-3888
Fax Number
248-363-0894
person
Provider Business Mailing Address Details
Address
9640 Commerce Rd Ste 102
City
State
Zip
48382-4167
Phone Number
248-360-3888
Fax Number
248-363-0894
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
GDS001605 (Michigan)
Definition
Definition to come...
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