institution
Long Lake Podiatry Pc
Foot & Ankle Surgery Podiatrist in Troy, Michigan
NPI 1962526624

Long Lake Podiatry Pc is a Foot & Ankle Surgery Podiatrist based in Troy, MI and is specialized in Foot & Ankle Surgery. Long Lake Podiatry Pc practices in Troy, MI. The NPI Number for Long Lake Podiatry Pc is 1962526624 and holds a License No. 5901001005 (Michigan).

The current practice location address for Long Lake Podiatry Pc is 2914 E Long Lake Rd, Troy, MI and can be reached out via phone at 248-528-0709 and via fax at 248-528-1807.

Location: 2914 E Long Lake Rd, Troy, MI, 48085-3780
institution
Provider Profile Details
NPI Number
1962526624
Provider Name
Long Lake Podiatry Pc
Credential
Provider Entity Type
Organization
Address
2914 E Long Lake Rd, Troy, MI, 48085-3780
Phone Number
248-528-0709
Fax Number
248-528-1807
Provider Enumeration Date
03/19/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5631470 01 MI BLUE CROSS BLUE SHIELD
89594B 01 MI HAP
1634294 05 MI
0005335144 01 MI AETNA
institution
Provider Business Practice Location Address Details
Address
2914 E Long Lake Rd
City
State
Zip
48085-3780
Phone Number
248-528-0709
Fax Number
248-528-1807
person
Provider Business Mailing Address Details
Address
2914 E Long Lake Rd
City
State
Zip
48085-3780
Phone Number
248-528-0709
Fax Number
248-528-1807
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...
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