Dearborn Podiatric Surgeons, P.C.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

5901000652 Issued in MI

Legal business name

DEARBORN PODIATRIC SURGEONS, P.C.

Practice address

22161 Outer Dr
Dearborn, MI 48124-3901

Phone

(313) 565-8080

Fax

(313) 565-2417

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence A. Young, D.P.M.

Title

Doctor

Phone

(313) 565-8080

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447467485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22161 W. OUTER DRIVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243901",
            "telephone_number": "313-565-8080",
            "fax_number": "313-565-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22161 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243901",
            "telephone_number": "313-565-8080",
            "fax_number": "313-565-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN PODIATRIC SURGEONS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "313-565-8080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901000652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1062616",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5825276",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "112003",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.