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NPI Code Detail

MEDICARE: MICHAEL P MASKILL DPM

MEDICARE: MICHAEL P MASKILL DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist5901002313MI
2213E00000XPodiatristPOD1063ME
3332900000XNon-Pharmacy Dispensing Site
4213ES0103XFoot & Ankle Surgery Podiatrist5901002313MI

General Provider Information

NPI Number : 1184886111
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL P MASKILL DPM
Provider Business Mailing Address
First Line : 7971 MOORSBRIDGE RD
Second Line :
City : PORTAGE
State : MI
Zip : 49024-4075
Country : US
Telephone Number : 269-323-2094
Fax Number : 269-323-2095
Provider Business Practice Location Address
First Line : 7971 MOORSBRIDGE RD
Second Line :
City : PORTAGE
State : MI
Zip : 49024-4075
Country : US
Telephone Number : 269-323-2094
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2008
Last Update Date : 10/23/2023

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Directions to “ MICHAEL P MASKILL DPM” Practice Location

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