=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063077998
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEVIN GARFIELD DPM PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2019
-----------------------------------------------------
Last Update Date | 10/07/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1775 E 14 MILE RD STE 100
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48009-7204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-642-3338
-----------------------------------------------------
Fax | 248-642-4939
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 829 BATAVIA AVE
-----------------------------------------------------
City | ROYAL OAK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48067-3339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-885-3846
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | DR. KEVIN GARFIELD
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 248-885-3846
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP1100X
-----------------------------------------------------
Taxonomy Name | Podiatric Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------