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General NPI Number Information
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NPI Number | 1053353540
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Entity Type | Organization
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Legal Business Name | DAVID W. MANSKY,D.P.M.,P.C.
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 5770 HIGHLAND RD SUITE 3
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City | WATERFORD
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State | MI
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Zip | 48327-1826
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Country | US
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Telephone | 248-674-3124
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Fax |
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Provider Business Mailing Address
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Address Line | 5770 HIGHLAND RD SUITE 3
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City | WATERFORD
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State | MI
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Zip | 48327-1826
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Country | US
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Telephone | 248-674-3124
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID W. MANSKY
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Credential | D.P.M.
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Telephone | 248-674-3124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5901001735
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License Number State | MI
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