| Physician And Feet Specialist, Pllc | |
|
10101 Fenkell St Suite B Detroit MI 48238-1645 | |
| (313) 834-4407 | |
| Not Available |
| Full Name | Physician And Feet Specialist, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10101 Fenkell St, Detroit, Michigan |
| Authorized Official Name and Position | Timothy Whiteus (OWNER) |
| Authorized Official Contact | 3138344407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician And Feet Specialist, Pllc Po Box 760127 Suite B Lathrup Village MI 48076-0127 Ph: (313) 834-4407 | Physician And Feet Specialist, Pllc 10101 Fenkell St Suite B Detroit MI 48238-1645 Ph: (313) 834-4407 |
| NPI Number | 1598996902 |
|---|---|
| Provider Enumeration Date | 08/03/2009 |
| Last Update Date | 08/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598996902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301406556 (Michigan) | Primary |
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