Healthcare Provider Details
I. General information
NPI: 1144457102
Provider Name (Legal Business Name): ASSOCIATED PODIATRISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2009
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26750 PROVIDENCE PKWY SUITE 130
NOVI MI
48374-1211
US
IV. Provider business mailing address
26750 PROVIDENCE PKWY SUITE 130
NOVI MI
48374-1211
US
V. Phone/Fax
- Phone: 248-348-5300
- Fax: 248-348-5410
- Phone: 248-348-5300
- Fax: 248-348-5410
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213EP1101X |
| Taxonomy | Primary Podiatric Medicine Podiatrist |
| License Number | 213E00000X |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
MARC
A
BOROVOY
Title or Position: PRESIDENT
Credential: DPM
Phone: 248-348-5300