Michigans Premier Foot And Ankle PLLC
Podiatrist, Foot & Ankle Surgery in Dearborn, MI. Organization (NPI-2).
NPI number1962045161
StatusActive
Last updated in NPPESOct 21, 2019
Details
- NPI
- 1962045161
- Entity type
- Organization (NPI-2)
- Legal business name
- Michigans Premier Foot And Ankle PLLC
- Organization subpart
- No
- Enumeration date
- Oct 21, 2019
- Last updated
- Oct 21, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | – | – | Yes |
Practice location
17000 Executive Plaza Dr Ste 101Dearborn, MI 48126-2793
Phone 313-565-4948 · Fax 313-565-4989
Mailing address
5861 Deepwood CtClarkston, MI 48346-3168
Authorized official
Alaa Mansour
Sole Member
6308089939
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