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General NPI Number Information
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NPI Number | 1972676047
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Entity Type | Organization
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Legal Business Name | STERLING HEIGHTS FOOT CARE, P.C.
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 43330 MOUND ROAD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-2022
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Country | US
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Telephone | 586-323-3668
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Fax | 586-323-4120
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Provider Business Mailing Address
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Address Line | 43330 MOUND ROAD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-2022
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Country | US
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Telephone | 586-323-3668
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Fax | 586-323-4120
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | DR. DAVID E. BENESON
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Credential | D.P.M.
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Telephone | 586-323-3668
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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 | DB001099
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License Number State | MI
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