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General NPI Number Information
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NPI Number | 1275454928
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Entity Type | Organization
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Legal Business Name | SOLE PURPOSE PODIATRY PLLC
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 16540 19 MILE RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1106
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Country | US
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Telephone | 586-286-8660
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Fax |
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Provider Business Mailing Address
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Address Line | 42384 BEECHWOOD DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-2944
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Country | US
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Telephone | 248-331-3237
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Fax |
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Authorized Official
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Title or Position | PODIATRIST-SELF
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Name | NADINE KASTAW
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Credential |
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Telephone | 248-331-3237
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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 |
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License Number State |
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