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General NPI Number Information
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NPI Number | 1154391985
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Entity Type | Organization
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Legal Business Name | SOUTHGATE FOOT AND ANKLE CENTER PLLC
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 14535 NORTHLINE RD.
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City | SOUTHGATE
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State | MI
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Zip | 48195-2446
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Country | US
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Telephone | 734-285-4200
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Fax | 734-285-9256
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Provider Business Mailing Address
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Address Line | 14535 NORTHLINE RD.
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City | SOUTHGATE
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State | MI
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Zip | 48195-2446
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Country | US
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Telephone | 734-285-4200
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Fax | 734-285-9256
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DANIEL T ZAHARI
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Credential | DPM
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Telephone | 734-285-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | DZ400138
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License Number State | MI
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