| Eastside Podiatry Pllc | |
|
24025 Greater Mack, Suite 101, Saint Clair Shores, MI 48080 | |
| (313) 884-7566 | |
| (313) 884-3140 |
| Full Name | Eastside Podiatry Pllc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 24025 Greater Mack, Saint Clair Shores, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144377821 | NPI | - | NPPES |
| 4476009 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 5901002021 (Michigan) | Primary |
| Provider Name | Taryn Russo |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174500862 PECOS PAC ID: 4385623420 Enrollment ID: I20040714000439 |
| Provider Name | Hatim T Burhani |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1366698524 PECOS PAC ID: 3274711098 Enrollment ID: I20110627000636 |
| Provider Name | Nicole M Brouyette |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1386907186 PECOS PAC ID: 3577877620 Enrollment ID: I20150803000915 |
| Provider Name | Siraj Panchbhaiya |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1962841544 PECOS PAC ID: 5193030583 Enrollment ID: I20150813011314 |
| Provider Name | Bhavik Patel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790300978 PECOS PAC ID: 2264854967 Enrollment ID: I20230615000874 |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Podiatry Pllc 24025 Greater Mack, Suite 101, St. Clair Shores, MI 48080-4311 Ph: (313) 884-7566 | Eastside Podiatry Pllc 24025 Greater Mack, Suite 101, Saint Clair Shores, MI 48080 Ph: (313) 884-7566 |
Shores Foot And Ankle Center Ltd. Podiatrist Medicare: Medicare Enrolled Practice Location: 22719 Garfield St, Saint Clair Shores, MI 48082 Phone: 586-294-7250 Fax: 586-294-7251 | |
Dr. Danielle Nicole Ronyak, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 27593 Harper Avenue, Saint Clair Shores, MI 48081 Phone: 586-779-6140 Fax: 586-779-9865 | |
Dr. Anthony V Benenati, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 27593 Harper, Saint Clair Shores, MI 48081 Phone: 586-779-6140 Fax: 586-779-9865 | |
Podcare Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 21327 Harper Ave, Suite C, Saint Clair Shores, MI 48080 Phone: 989-791-2455 Fax: 989-791-2455 | |
Dr. Neil T Shaw, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 27593 Harper, Saint Clair Shores, MI 48081 Phone: 586-779-6140 Fax: 586-779-9865 | |
Dr. Julie Anna Mrozek, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 27593 Harper Ave, Saint Clair Shores, MI 48081 Phone: 586-779-6140 Fax: 586-779-9865 |