Podiatry Examiners of Michigan PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0814 Issued in MI

Legal business name

PODIATRY EXAMINERS OF MICHIGAN PC

Practice address

3800 Woodward Avenue
Suite 318
Detroit, MI 48201-2066

Phone

(313) 833-3096

Fax

(313) 833-7843

NPI assigned

Aug 17, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Craig Marshall Gastwirth, DPM

Title

President

Phone

(313) 833-3090

Specialties & licenses 1

Addresses

Other identifiers 9

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1336252857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVENUE",
            "address_2": "SUITE 318",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012066",
            "telephone_number": "313-833-3096",
            "fax_number": "313-833-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVENUE",
            "address_2": "SUITE 318",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012066",
            "telephone_number": "313-833-3096",
            "fax_number": "313-833-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY EXAMINERS OF MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "GASTWIRTH",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "MARSHALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-833-3090",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "0814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1260775",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA CHOICE CARE",
            "identifier": "P00248",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "U23902",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLNESS PLAN",
            "identifier": "123985",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE HEALTH PLAN",
            "identifier": "15982",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMICARE HEALTH PLAN",
            "identifier": "20094",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "002631",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0961720001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4888250510",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Detroit, MI
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.