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General NPI Number Information
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NPI Number | 1699319806
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE SPECIALISTS OF MID-MICHIGAN PC
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 111 E WACKERLY ST STE B
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City | MIDLAND
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State | MI
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Zip | 48642-7043
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Country | US
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Telephone | 989-488-6355
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Fax | 989-486-9051
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Provider Business Mailing Address
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Address Line | 111 E WACKERLY ST STE B
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City | MIDLAND
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State | MI
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Zip | 48642-7043
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Country | US
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Telephone | 989-488-6355
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Fax | 989-486-9051
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Authorized Official
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Title or Position | OWNER
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Name | HEIDI E MONAGHAN
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Credential | DPM
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Telephone | 989-488-6355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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