Eastside Podiatry Pllc in St. Clair Shores - Foot & Ankle Surgery
Eastside Podiatry Pllc - NPI 1144377821
Eastside Podiatry Pllc is a Foot & Ankle Surgery in St. Clair Shores, Michigan. Eastside Podiatry Pllc practices all healthcare services and medical treatments related to Foot & Ankle Surgery. The NPI Number for Eastside Podiatry Pllc is 1144377821. The last update date is 2018-05-22.
Eastside Podiatry Pllc's current location address is 24025 Greater Mack, St. Clair Shores, Michigan. You can contact this provider via phone number 3138847566 and fax number 3138843140. The mailing address for Eastside Podiatry Pllc is 24025 Greater Mack, St. Clair Shores, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Eastside Podiatry Pllc |
|---|---|
| Address | 24025 Greater Mack, St. Clair Shores, Michigan |
| Phone Number | 3138847566 |
| Fax Number | 3138843140 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Burhani Tahir Hatim |
| Credentials | DPM |
| Telephone Number | 3138847566 |
NPI Number Detail
| NPI Number | 1144377821 |
|---|---|
| Provider Enumeration Date | 2007-01-04 |
| Last Updated Date | 2018-05-22 |
Provider Mailing Address Detail
| Address | 24025 Greater Mack |
|---|---|
| City | St. Clair Shores |
| State | Michigan (MI) |
| Post Code | 480804311 |
| Phone Number | 3138847566 |
| Fax Number | 3138843140 |
Provider's Primary Taxonomy Detail
| Speciality | Foot & Ankle Surgery |
|---|---|
| Taxonomy | 213Es0103X |
| Licence No | 5901002021 |
|
Definition: A doctor of podiatric medicine who diagnoses and treats disorders and injuries to the foot, ankle and related structures. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4476009 | MI | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Eastside Podiatry Pllc?
The Eastside Podiatry Pllc has been issued the NPI (National Provider Identifier) 1144377821 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Eastside Podiatry Pllc is geographically located?
The Eastside Podiatry Pllc is physically situated at the following location: 24025 Greater Mack, St. Clair Shores, MI, 480804311.
What is Eastside Podiatry Pllc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Eastside Podiatry Pllc is Foot & Ankle Surgery, and the taxonomy code that classifies this field of practice is 213Es0103X.
When was the Eastside Podiatry Pllc's 1144377821 issued?
The Eastside Podiatry Pllc's 1144377821 was issued on 2007-01-04.
As of what date was the information regarding Eastside Podiatry Pllc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Eastside Podiatry Pllc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2018-05-22.
NPI Number: 1982607784
Address: 54045 Ridge Rd, Yucca Valley, CA