Great Lakes Podiatry Associates PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

5901000581 Issued in MI

Legal business name

GREAT LAKES PODIATRY ASSOCIATES PLLC

Practice address

3560 Pontiac Lake Rd
Waterford, MI 48328-2337

Phone

(248) 674-2575

Fax

(248) 674-0577

NPI assigned

May 9, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sheldon J Goldstein, DPM

Title

President

Phone

(248) 674-2575

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1316393309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 PONTIAC LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282337",
            "telephone_number": "248-674-2575",
            "fax_number": "248-674-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 PONTIAC LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282337",
            "telephone_number": "248-674-2575",
            "fax_number": "248-674-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PODIATRY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "SHELDON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-674-2575",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901000581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Lashawn Graves
• Kateri Gray, LLMSW
• Samuel Adam Gray, DC
• Great Lakes Clinical Group, P.C
• Great Lakes Neuromonitoring, PLLC
• Greater Oakland Visiting Nurse Association, Inc.
• Susan Marie Grech, RN
• Briana Greenlee, RDN
• Greentechconcept
• Greentechconcept Inc

• Foot & Ankle Surgery Podiatrist in Waterford, MI
• Providers in Waterford, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.