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NPI Code Detail

MEDICARE: LAKES AREA FOOT AND ANKLE CARE, PLLC

MEDICARE: LAKES AREA FOOT AND ANKLE CARE, 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
1213ES0103XFoot & Ankle Surgery Podiatrist5315007043MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14856351900OTHERBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902159437
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKES AREA FOOT AND ANKLE CARE, PLLC
Provider Business Mailing Address
First Line : PO BOX 1355
Second Line :
City : WALLED LAKE
State : MI
Zip : 48390-5355
Country : US
Telephone Number : 248-425-8124
Fax Number :
Provider Business Practice Location Address
First Line : 620 N PONTIAC TRL
Second Line :
City : WALLED LAKE
State : MI
Zip : 48390-3448
Country : US
Telephone Number : 248-425-8124
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. ROSS FEINMAN
Credential : DPM
Telephone Number : 248-425-8124
Provider Enumeration Date : 10/22/2012
Last Update Date : 10/22/2012

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