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GRAND TRAVERSE FOOT & ANKLE CENTER P.C. NPI 1396928297


NPI Information

NPI: 1396928297
Provider Name: GRAND TRAVERSE FOOT & ANKLE CENTER P.C.
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
4246 N. THREE MILE RD.
TRAVERSE CITY, MI
ZIP 49686
Phone: (231) 922-9100
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GRAND TRAVERSE FOOT & ANKLE CENTER P.C. is a podiatrist in Traverse City, 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. GRAND TRAVERSE FOOT & ANKLE CENTER P.C. NPI is 1396928297. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4246 N. THREE MILE RD.
TRAVERSE CITY, MI
ZIP 49686
Phone: (231) 922-9100
Fax: (231) 922-9180

The provider's authorized official is Theresa Marie Zywicki .
The authorized official title is Office Manager and has the following contact phone number (231) 922-9100.

The enumeration date for this NPI number is 12/13/2007 and was last updated on 7/10/2013.


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
1213E00000XPodiatrist5901001664MICHIGANYes

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
14557980001MEDICARE NSCMICHIGAN
2132893049MEDICAIDMICHIGAN
3U13351MEDICARE UPINMICHIGAN
40P52510MEDICARE PINMICHIGAN

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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