institution
East Side Foot & Ankle Clinic Pc
Customized Equipment (DME) in Saint Clair Shores, Michigan
NPI 1801910229

East Side Foot & Ankle Clinic Pc is a Customized Equipment (DME) based in Saint Clair Shores, MI and is specialized in Customized Equipment. East Side Foot & Ankle Clinic Pc practices in Saint Clair Shores, MI. The NPI Number for East Side Foot & Ankle Clinic Pc is 1801910229 and holds a License No. 5901001005 (Michigan).

The current practice location address for East Side Foot & Ankle Clinic Pc is 22301 Greater Mack Ave, Saint Clair Shores, MI and can be reached out via phone at 586-776-7000 and via fax at 586-776-7003.

Location: 22301 Greater Mack Ave, Saint Clair Shores, MI, 48080-2376
institution
Provider Profile Details
NPI Number
1801910229
Provider Name
East Side Foot & Ankle Clinic Pc
Credential
Provider Entity Type
Organization
Address
22301 Greater Mack Ave, Saint Clair Shores, MI, 48080-2376
Phone Number
586-776-7000
Fax Number
586-776-7003
Provider Enumeration Date
03/19/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2926711 05 MI
89594B 01 MI HAP
480014028 01 MI RAILROAD MEDICARE PTAN
0005335144 01 MI AETNA
0Q24605 01 MI BLUECROSS PIN
institution
Provider Business Practice Location Address Details
Address
22301 Greater Mack Ave
City
State
Zip
48080-2376
Phone Number
586-776-7000
Fax Number
586-776-7003
person
Provider Business Mailing Address Details
Address
22301 Greater Mack Ave
City
State
Zip
48080-2376
Phone Number
586-776-7000
Fax Number
586-776-7003
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
5901001005 (Michigan)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
License No.
5901001005 (Michigan)
Definition
Definition to come...
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