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TROY PODIATRIST PC NPI 1033219209


NPI Information

NPI: 1033219209
Provider Name: TROY PODIATRIST PC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
4770 ROCHESTER RD
SUITE 104
TROY, MI
ZIP 48085
Phone: (248) 689-5125
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TROY PODIATRIST PC is a podiatrist in Troy, MI. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. TROY PODIATRIST PC NPI is 1033219209. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4770 ROCHESTER RD
SUITE 104
TROY, MI
ZIP 48085-951
Phone: (248) 689-5125
Fax: (248) 689-5688

The provider's authorized official is Steven Glickman .
The authorized official title is Owner and has the following contact phone number (248) 689-5125.

The enumeration date for this NPI number is 9/25/2006 and was last updated on 8/27/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristSG000600MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11375192-13MEDICAIDMICHIGAN
2T34182MEDICARE UPINMICHIGAN
3C2490OTHERMICHIGANMCARE
4480013308OTHERMICHIGANRAILROAD MEDICARE
56235430001MEDICARE NSCMICHIGAN
60F37223MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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