Healthcare Provider Details

I. General information

NPI: 1417013210
Provider Name (Legal Business Name): FOOT SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21111 MIDDLEBELT RD
FARMINGTON HILLS MI
48336-5549
US

IV. Provider business mailing address

21111 MIDDLEBELT RD
FARMINGTON HILLS MI
48336
US

V. Phone/Fax

Practice location:
  • Phone: 248-478-1150
  • Fax: 248-478-1156
Mailing address:
  • Phone: 248-478-1150
  • Fax: 248-478-1156

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: JENNIFER L ARMSTRONG
Title or Position: OFFICE COORDINATOR
Credential:
Phone: 248-478-1150