Healthcare Provider Details

I. General information

NPI: 1053381897
Provider Name (Legal Business Name): MARVIN ARONOVITZ D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13479 E 14 MILE RD
STERLING HEIGHTS MI
48312-6304
US

IV. Provider business mailing address

3408 WEST RD
TRENTON MI
48183-2323
US

V. Phone/Fax

Practice location:
  • Phone: 586-264-7300
  • Fax: 586-268-4630
Mailing address:
  • Phone: 734-676-4664
  • Fax: 734-676-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberMA000522
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: