Healthcare Provider Details

I. General information

NPI: 1942257969
Provider Name (Legal Business Name): ROBERT D ADAS DPM & LARRY H WEXLER DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26831 WOODWARD AVE
HUNTINGTON WOODS MI
48070-1326
US

IV. Provider business mailing address

26831 WOODWARD AVE
HUNTINGTON WOODS MI
48070-1326
US

V. Phone/Fax

Practice location:
  • Phone: 248-399-5905
  • Fax: 248-399-5906
Mailing address:
  • Phone: 248-399-5905
  • Fax: 248-399-5906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0922
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0940
License Number StateMI

VIII. Authorized Official

Name: DR. ROBERT DONALD ADAS
Title or Position: VICE PRESIDENT
Credential: D.P.M.
Phone: 248-399-5905