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General NPI Number Information
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NPI Number | 1801992557
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Entity Type | Organization
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Legal Business Name | ASCENSION MEDICAL GROUP MICHIGAN
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 13935 PLUMBROOK RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-1727
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Country | US
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Telephone | 586-939-9900
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Fax | 586-939-8246
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Provider Business Mailing Address
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Address Line | PO BOX 14129
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City | BELFAST
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State | ME
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Zip | 04915-4032
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Country | US
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Telephone | 248-680-8000
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Fax | 248-292-3852
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Authorized Official
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Title or Position | MANAGER
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Name | RACHEL R PERRY
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Credential |
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Telephone | 248-221-1918
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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 | 5901002120
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number | 5901002120
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5901002120
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 5901002120
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 5901002120
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License Number State | MI
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