MEDICARE: DR. AIMEE ANTOINETTE POPOFSKI DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	5901002236	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00921459	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5631521	OTHER	MI	BCBS OF MICHIGAN

General Provider Information

NPI Number	:	1790880284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AIMEE ANTOINETTE POPOFSKI DPM

Provider Business Mailing Address
First Line	:	9640 COMMERCE RD
Second Line	:	SUITE 102
City	:	COMMERCE TWP
State	:	MI
Zip	:	48382-4166
Country	:	US
Telephone Number	:	248-360-3888
Fax Number	:	248-363-0894

Provider Business Practice Location Address
First Line	:	29433 RYAN RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48092-2203
Country	:	US
Telephone Number	:	865-574-0500
Fax Number	:	586-574-2694

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	03/12/2020

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Directions to “ DR. AIMEE ANTOINETTE POPOFSKI DPM” Practice Location

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