Healthcare Provider Details

I. General information

NPI: 1407728108
Provider Name (Legal Business Name): EPIC FOOT & ANKLE SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 LIVINGSTON ST STE 1
BAY CITY MI
48708-6392
US

IV. Provider business mailing address

720 LIVINGSTON ST STE 1
BAY CITY MI
48708-6392
US

V. Phone/Fax

Practice location:
  • Phone: 989-895-8594
  • Fax: 989-895-8748
Mailing address:
  • Phone: 989-895-8594
  • Fax: 989-895-8748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: MOHOMAD AL-SAWAH
Title or Position: MEMBER
Credential: DPM
Phone: 989-895-8594