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General NPI Number Information
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NPI Number | 1841231891
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE ASSOC. PLLC
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 44000 W 12 MILE RD SUITE 111
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City | NOVI
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State | MI
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Zip | 48377-3111
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Country | US
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Telephone | 248-347-8233
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Fax | 248-347-8174
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Provider Business Mailing Address
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Address Line | PO BOX 3195
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City | FARMINGTON HILLS
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State | MI
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Zip | 48333-3195
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Country | US
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Telephone | 248-347-8233
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Fax | 248-347-8174
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. MARIE NELSON
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Credential | DPM
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Telephone | 248-347-8233
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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 | 5901001597
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License Number State | MI
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