| |
1104 Ashmun St, Sault Sainte Marie, MI 49783-2710 | |
(906) 635-9511 | |
(906) 635-9529 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 1104 Ashmun St, Sault Sainte Marie, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548442858 | NPI | - | NPPES |
1310710002 | Other | TN | CIGNA GOVERNMENT SERVICES |
0B44565 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | DH5901001212 (Michigan) | Primary |
Mailing Address | Practice Location Address |
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2233 Mitchell Park Dr, Petoskey, MI 49770-9600 Ph: (231) 347-3440 | 1104 Ashmun St, Sault Sainte Marie, MI 49783-2710 Ph: (906) 635-9511 |