East Side Foot & Ankle Clinic Pc

LBN: East Side Foot & Ankle Clinic Pc
East Side Foot & Ankle Clinic Pc is an health care organization with primary practice located at 22301 Greater Mack Ave Suite 3, Saint Clair Shores MI 48080-2376. The organization recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Suppliers / Customized Equipment. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is the primary health care specialty. East Side Foot & Ankle Clinic Pc can be contacted via phone (586) 776-7000, or through Berlin, David via phone (586) 776-7000.

Contact Information

Primary practice address
22301 Greater Mack Ave Suite 3 Saint Clair Shores MI 48080-2376
Fax: (586) 776-7003
Website:
Authorized official contact:
Name: Berlin, David Doctor of Podiatric Medicine (DPM)

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 5901001005 Michigan
Suppliers / Customized Equipment 332BC3200X 5901001005 Michigan

Profile Details

NPI number 1801910229
LBN Legal business name East Side Foot & Ankle Clinic Pc
DBA Doing business as
Authorized official Berlin, David Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 19th, 2007
Last updated Aug 4th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801910229 NPPES
Michigan MEDICAID 2926711
Michigan Other 89594B
Michigan Other 480014028
Michigan Other 0005335144
Michigan Other 0Q24605

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