Healthcare Provider Details

I. General information

NPI: 1992363097
Provider Name (Legal Business Name): MATTHEW D ANDREWS DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W BIG BEAVER RD STE 150
TROY MI
48084-3535
US

IV. Provider business mailing address

1800 W BIG BEAVER RD STE 150
TROY MI
48084-3535
US

V. Phone/Fax

Practice location:
  • Phone: 248-808-6012
  • Fax: 248-429-1501
Mailing address:
  • Phone: 248-808-6012
  • Fax: 248-429-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW D ANDREWS
Title or Position: PRESIDENT
Credential: DPM
Phone: 810-265-9227