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General NPI Number Information
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NPI Number | 1720228976
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Entity Type | Organization
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Legal Business Name | FOOT CARE SERVICES PLLC
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Dates
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Enumeration Date | 02/28/2009
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 6304 SADDLE RIDGE CT
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City | KALAMAZOO
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State | MI
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Zip | 49009-4000
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Country | US
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Telephone | 269-267-2929
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1177
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City | PORTAGE
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State | MI
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Zip | 49081-1177
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMED JAMALUDDIN
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Credential | D.P.M.
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Telephone | 269-267-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 5901001615
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License Number State | MI
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