| |
11650 Belleville Rd, Belleville, MI 48111-3380 | |
(734) 699-2400 | |
(734) 699-3669 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 11650 Belleville Rd, Belleville, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598062036 | NPI | - | NPPES |
480F364180 | Other | MI | BLUE CROSS BLUE SHIELD |
54938D | Other | MI | HAP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 5901000671 (Michigan) | Primary |
Mailing Address | Practice Location Address |
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21111 Middlebelt Rd, Farmington Hills, MI 48336-5549 Ph: (248) 478-1150 | 11650 Belleville Rd, Belleville, MI 48111-3380 Ph: (734) 699-2400 |