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General NPI Number Information
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NPI Number | 1962570853
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Entity Type | Organization
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Legal Business Name | ASSOCIATED FOOT CLINIC OF FENTON, P.C.
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 102 N ADELAIDE ST
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City | FENTON
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State | MI
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Zip | 48430-2670
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Country | US
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Telephone | 810-750-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 191 N PARK BLVD
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City | LAKE ORION
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State | MI
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Zip | 48362
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Country | US
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Telephone | 810-693-8400
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Fax | 810-693-3970
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY C NOROYAN
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Credential | D.P.M.
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Telephone | 810-750-8300
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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 | JN001106
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License Number State | MI
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