Healthcare Provider Details

I. General information

NPI: 1467630830
Provider Name (Legal Business Name): MICHAEL A. HARTMAN DPM.PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N SHELDON RD
PLYMOUTH MI
48170-1524
US

IV. Provider business mailing address

215 N SHELDON RD
PLYMOUTH MI
48170-1524
US

V. Phone/Fax

Practice location:
  • Phone: 734-455-3669
  • Fax: 734-455-3797
Mailing address:
  • Phone: 734-455-3669
  • Fax: 734-455-3797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberMH001532
License Number StateMI

VIII. Authorized Official

Name: MS. TAMMY LEE HALEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 734-455-3669