Healthcare Provider Details

I. General information

NPI: 1891880845
Provider Name (Legal Business Name): DONALD M SOLOMON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23423 RYAN DONALD SOLOMON DPM
WARREN MI
48091-1927
US

IV. Provider business mailing address

23423 RYAN DONALD SOLOMON DPM
WARREN MI
48091-1927
US

V. Phone/Fax

Practice location:
  • Phone: 586-755-0022
  • Fax: 586-755-0066
Mailing address:
  • Phone: 586-755-0022
  • Fax: 586-755-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberDS000554
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: