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General NPI Number Information
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NPI Number | 1134885809
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PODIATRY SERVICES
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Dates
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Enumeration Date | 11/16/2021
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 803 W LAYTON AVENUE
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City | MILWAUKEE
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State | WI
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Zip | 53221-2426
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Country | US
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Telephone | 414-253-8330
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Fax | 414-244-9957
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Provider Business Mailing Address
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Address Line | 7971 SOUTH SIXTH STREET STE 322
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City | OAK CREEK
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State | WI
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Zip | 53154-2034
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Country | US
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Telephone | 414-253-8330
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Fax | 414-244-9957
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Authorized Official
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Title or Position | PRESIDENT
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Name | SYEDA ROSHAN
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Credential | DPM
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Telephone | 142-568-3304
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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