Healthcare Provider Details

I. General information

NPI: 1235321407
Provider Name (Legal Business Name): COMPREHENSIVE FOOT AND ANKLE CENTERS OF MICHIGAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30055 NORTHWESTERN HWY SUITE L40
FARMINGTON HILLS MI
48334-3230
US

IV. Provider business mailing address

22401 FOSTER WINTER DR
SOUTHFIELD MI
48075-3724
US

V. Phone/Fax

Practice location:
  • Phone: 248-851-4900
  • Fax: 248-851-4901
Mailing address:
  • Phone: 248-423-5166
  • Fax: 248-423-5125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: MILTON J STERN
Title or Position: PRESIDENT
Credential: DPM
Phone: 248-851-4900