Healthcare Provider Details

I. General information

NPI: 1336192533
Provider Name (Legal Business Name): ROCHESTER CENTER FOR FOOT AND ANKLE SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 W UNIVERSITY DR SUITE 235
ROCHESTER MI
48307-1871
US

IV. Provider business mailing address

1135 W UNIVERSITY DR SUITE 235
ROCHESTER MI
48307-1871
US

V. Phone/Fax

Practice location:
  • Phone: 248-651-0162
  • Fax: 248-651-1022
Mailing address:
  • Phone: 248-651-0162
  • Fax: 248-651-1022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberCK000960
License Number StateMI

VIII. Authorized Official

Name: CINDY SMITH
Title or Position: MANAGER
Credential:
Phone: 586-574-0500