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General NPI Number Information
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NPI Number | 1932279437
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Entity Type | Organization
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Legal Business Name | NATIONWIDE FOOT & ANKLE CARE PC
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 10986 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48150-3058
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Country | US
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Telephone | 734-261-3400
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Fax | 734-261-3411
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Provider Business Mailing Address
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Address Line | 10986 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48150-3058
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Country | US
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Telephone | 734-261-3400
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Fax | 734-261-3411
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Authorized Official
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Title or Position | OWNER-PRESIDENT
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Name | DR. RANDY BERNSTEIN
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Credential | D.P.M.
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Telephone | 734-261-3400
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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 | 5901001223
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License Number State | MI
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