MEDICARE: PRECISION PODIATRY PLLC

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
1	213EP1101X	Primary Podiatric Medicine Podiatrist

General Provider Information

NPI Number	:	1770104994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION PODIATRY PLLC

Provider Business Mailing Address
First Line	:	917 N LAFAYETTE ST
Second Line	:
City	:	GREENVILLE
State	:	MI
Zip	:	48838-1129
Country	:	US
Telephone Number	:	616-754-9580
Fax Number	:	616-754-9519

Provider Business Practice Location Address
First Line	:	917 N LAFAYETTE ST
Second Line	:
City	:	GREENVILLE
State	:	MI
Zip	:	48838-1129
Country	:	US
Telephone Number	:	616-754-9580
Fax Number	:	616-754-9519

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FADI JAAFAR
Credential	:	DPM
Telephone Number	:	313-203-6002

Provider Enumeration Date	:	04/28/2020
Last Update Date	:	12/26/2024

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