Healthcare Provider Details

I. General information

NPI: 1609821024
Provider Name (Legal Business Name): MICHAEL W KRUPIC DPM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 S MILFORD RD
HIGHLAND MI
48357-4985
US

IV. Provider business mailing address

3061 CHRISTY WAY
SAGINAW MI
48603-2267
US

V. Phone/Fax

Practice location:
  • Phone: 248-685-3668
  • Fax:
Mailing address:
  • Phone: 989-791-2455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number5315011987
License Number StateMI

VIII. Authorized Official

Name: MICHAEL W KRUPIC
Title or Position: OWNER
Credential: DPM
Phone: 248-685-3668